1134733249 NPI number — M A S SALUD, INC

Table of content: SARAH ELIZABETH CRAVEY KRAUS LPC (NPI 1275421877)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134733249 NPI number — M A S SALUD, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
M A S SALUD, INC
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:
1134733249
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/10/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
51025 AVENIDA MENDOZA STE 201
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LA QUINTA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92253-7409
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-609-2012
Provider Business Mailing Address Fax Number:
760-766-1796

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
51025 AVENIDA MENDOZA STE 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LA QUINTA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92253-7409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-609-2012
Provider Business Practice Location Address Fax Number:
760-766-1796
Provider Enumeration Date:
09/04/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SOTO
Authorized Official First Name:
MARICELA
Authorized Official Middle Name:
ANDREA
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
760-609-2012

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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