1215336805 NPI number — DR. STEPHANIE FOSTER, PHD, OTR/L

Table of content: (NPI 1215336805)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215336805 NPI number — DR. STEPHANIE FOSTER, PHD, OTR/L

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. STEPHANIE FOSTER, PHD, OTR/L
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:
1215336805
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/19/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2476
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORCUTT
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93457-2476
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-264-1553
Provider Business Mailing Address Fax Number:
949-215-4281

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
652 WILDFLOWER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA MARIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93455-6099
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-264-1553
Provider Business Practice Location Address Fax Number:
949-215-4281
Provider Enumeration Date:
08/19/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PELOQUIN
Authorized Official First Name:
MELINDA
Authorized Official Middle Name:
Authorized Official Title or Position:
ACCOUNT MANAGER
Authorized Official Telephone Number:
949-215-5008

Provider Taxonomy Codes

  • Taxonomy code: 225XF0002X , with the licence number:  OT3616 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XP0200X , with the licence number: OT3616 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X , with the licence number: SP20089 , 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: ZZZ77913Y . This is a "BS GROUP - OT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: ZZZ78575Y . This is a "BS GROUP - SPEECH" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".