1437289543 NPI number — SANTA CLARA COUNTY DRUG AND ALCHOHOL SERVICES

Table of content: DR. MORGAN PAYNE STEWART PHARMD (NPI 1629597273)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437289543 NPI number — SANTA CLARA COUNTY DRUG AND ALCHOHOL SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SANTA CLARA COUNTY DRUG AND ALCHOHOL SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437289543
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2425 ENBORG LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95128-2648
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2425 ENBORG LANE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-885-5400
Provider Business Practice Location Address Fax Number:
408-885-3360
Provider Enumeration Date:
03/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HARGREAVES
Authorized Official First Name:
SCOTT
Authorized Official Middle Name:
Authorized Official Title or Position:
PSYCHIATRIC TECHNICIAN
Authorized Official Telephone Number:
408-885-5400

Provider Taxonomy Codes

  • Taxonomy code: 284300000X , with the licence number:  PT25769 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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