1871631853 NPI number — RUTH H KASPAR AUD

Table of content: RUTH H KASPAR AUD (NPI 1871631853)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871631853 NPI number — RUTH H KASPAR AUD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KASPAR
Provider First Name:
RUTH
Provider Middle Name:
H
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
AUD
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:
1871631853
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/25/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
550 WATER ST STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA CRUZ
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95060-4126
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
831-476-4414
Provider Business Mailing Address Fax Number:
831-476-0264

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
550 WATER ST STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA CRUZ
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95060-4126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-476-4414
Provider Business Practice Location Address Fax Number:
831-476-0264
Provider Enumeration Date:
02/02/2007

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: 231H00000X , with the licence number:  AU2125 , 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)

  • Identifier: AU2125 . This is a "AUDIOLOGY LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".