1053583351 NPI number — DR. JANET RUTH BACHELER PH.D.

Table of content: DR. JANET RUTH BACHELER PH.D. (NPI 1053583351)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053583351 NPI number — DR. JANET RUTH BACHELER PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BACHELER
Provider First Name:
JANET
Provider Middle Name:
RUTH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
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:
1053583351
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/10/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 1482
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PENN VALLEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95946-1482
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
530-798-7979
Provider Business Mailing Address Fax Number:
530-798-7979

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11246 PLEASANT VALLEY ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PENN VALLEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95946
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-798-7979
Provider Business Practice Location Address Fax Number:
530-798-7979
Provider Enumeration Date:
03/26/2008

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: 103T00000X , with the licence number:  PSY14701 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: PSY14701 , 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)