1386689859 NPI number — MRS. CAROL LOWREY HIPPERT MA

Table of content: MRS. CAROL LOWREY HIPPERT MA (NPI 1386689859)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386689859 NPI number — MRS. CAROL LOWREY HIPPERT MA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HIPPERT
Provider First Name:
CAROL
Provider Middle Name:
LOWREY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MA
Provider Gender Code:
F

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:
1386689859
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/14/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
28392 CHAMPIONS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MENIFEE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92584
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-807-9892
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11201 BENTON ST
Provider Second Line Business Practice Location Address:
VA LOMA LINDA HEALTHCARE SYSTEM
Provider Business Practice Location Address City Name:
LOMA LINDA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92357
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-825-7084
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  AU 646 , 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: AU 646 . This is a "DISPENSING AUDIOLOGIST" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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