1437402815 NPI number — OLGA ACEVEDO CADC-CAS

Table of content: OLGA ACEVEDO CADC-CAS (NPI 1437402815)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437402815 NPI number — OLGA ACEVEDO CADC-CAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ACEVEDO
Provider First Name:
OLGA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CADC-CAS
Provider Gender Code:
F

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:
1437402815
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1001 TOWER WAY STE 150A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAKERSFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93309-1597
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-634-9877
Provider Business Mailing Address Fax Number:
661-864-0198

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 TOWER WAY STE 150A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-1597
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-634-9877
Provider Business Practice Location Address Fax Number:
661-864-0198
Provider Enumeration Date:
10/22/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YA0400X , with the licence number: S0412311706 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YA0400X , with the licence number: C050090118 , 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)