1285275420 NPI number — REFLECTIVE MINDS LLC

Table of content: (NPI 1285275420)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285275420 NPI number — REFLECTIVE MINDS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REFLECTIVE MINDS LLC
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:
1285275420
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/30/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7352
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRECKELS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93962-7352
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
831-915-7434
Provider Business Mailing Address Fax Number:
888-242-4398

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
137 CENTRAL AVE STE 5A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALINAS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93901-2656
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-915-7434
Provider Business Practice Location Address Fax Number:
888-242-4398
Provider Enumeration Date:
09/30/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PETERSON
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
STEPHEN
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
831-915-7434

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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