1710137120 NPI number — DAISY SOLEDAD NAVARRO BA SOCIOLOGY

Table of content: DAISY SOLEDAD NAVARRO BA SOCIOLOGY (NPI 1710137120)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710137120 NPI number — DAISY SOLEDAD NAVARRO BA SOCIOLOGY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NAVARRO
Provider First Name:
DAISY
Provider Middle Name:
SOLEDAD
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
BA SOCIOLOGY
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:
1710137120
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/22/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 S MAIN ST
Provider Second Line Business Mailing Address:
SUITE 1100
Provider Business Mailing Address City Name:
ORANGE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92868-4507
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-543-4333
Provider Business Mailing Address Fax Number:
714-543-4398

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 S MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 1100
Provider Business Practice Location Address City Name:
ORANGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92868-4507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-543-4333
Provider Business Practice Location Address Fax Number:
714-543-4398
Provider Enumeration Date:
09/22/2008

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: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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