1205528478 NPI number — AC WELLNESS ON DEMAND MEDICAL, PLLC

Table of content: SARAH KATHRYN JONES PT (NPI 1730499666)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205528478 NPI number — AC WELLNESS ON DEMAND MEDICAL, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AC WELLNESS ON DEMAND MEDICAL, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
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Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
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Provider Other Last Name:
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NPI Number Information

NPI Number:
1205528478
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/24/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20730 VALLEY GREEN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CUPERTINO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95014-1704
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20730 VALLEY GREEN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CUPERTINO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95014-1704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-783-4000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/24/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PAKDAMAN
Authorized Official First Name:
NEDA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
650-704-3161

Provider Taxonomy Codes

  • Taxonomy code: 261QC1800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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