1467894378 NPI number — JAMES SLOAN OPTOMETRY, A PROFESSIONAL CORPORATION

Table of content: JENAE MICHELLE HESSE APRN (NPI 1912556051)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467894378 NPI number — JAMES SLOAN OPTOMETRY, A PROFESSIONAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAMES SLOAN OPTOMETRY, A PROFESSIONAL CORPORATION
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:
SLOAN OPTOMETRY
Provider Other Organization Name Type Code:
3
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:
1467894378
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/03/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13321 MOORPARK ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHERMAN OAKS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91423-3917
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-501-5565
Provider Business Mailing Address Fax Number:
818-784-2894

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13321 MOORPARK ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHERMAN OAKS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91423-3917
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-501-5565
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/19/2013

Additional Information

Authorized Official

Authorized Official Last Name:
SLOAN
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
R
Authorized Official Title or Position:
OWNER/OPTOMETRIST
Authorized Official Telephone Number:
818-501-5565

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  14555 TLG , 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)





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