1316354830 NPI number — DONALD S STAAB JR, FNP & JOSE R SANCHEZ, MD

Table of content: MS. EMILY JUDITH SCHNIPPER THW (NPI 1710544150)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316354830 NPI number — DONALD S STAAB JR, FNP & JOSE R SANCHEZ, MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DONALD S STAAB JR, FNP & JOSE R SANCHEZ, MD
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:
1316354830
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3625 MISSION AVE STE D
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARMICHAEL
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95608-2954
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-486-1906
Provider Business Mailing Address Fax Number:
916-486-1206

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3625 MISSION AVE STE D
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARMICHAEL
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95608-2954
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-486-1906
Provider Business Practice Location Address Fax Number:
916-486-1206
Provider Enumeration Date:
07/16/2014

Additional Information

Authorized Official

Authorized Official Last Name:
SLECHTA
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
G
Authorized Official Title or Position:
OFFICE ADMINISTRATOR
Authorized Official Telephone Number:
916-601-4513

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  G61393 , 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: NP0020190 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com