1043163256 NPI number — MOLLI JAYNE NAJERA CADC-R, CRM

Table of content: MOLLI JAYNE NAJERA CADC-R, CRM (NPI 1043163256)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043163256 NPI number — MOLLI JAYNE NAJERA CADC-R, CRM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NAJERA
Provider First Name:
MOLLI
Provider Middle Name:
JAYNE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CADC-R, CRM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LEESON
Provider Other First Name:
MOLLI
Provider Other Middle Name:
JAYNE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRM
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1043163256
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/17/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
32405 DIAGONAL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HERMISTON
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97838-7503
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-720-4679
Provider Business Mailing Address Fax Number:
888-977-2106

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
32773 W WALLS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HERMISTON
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97838-6364
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-720-4679
Provider Business Practice Location Address Fax Number:
888-977-2106
Provider Enumeration Date:
02/17/2026

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 , with the licence number:  700110 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2026 www.npivalidator.com