1770979171 NPI number — REGENTS OF THE UNIVERSITY OF CALIFORNIA

Table of content: ILENE SPERLING MA, CCC (NPI 1467574806)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770979171 NPI number — REGENTS OF THE UNIVERSITY OF CALIFORNIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REGENTS OF THE UNIVERSITY OF CALIFORNIA
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:
6
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:
1770979171
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5767 W CENTURY BLVD
Provider Second Line Business Mailing Address:
400
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90045-5631
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-301-8707
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23861 MCBEAN PKWY STE E24
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VALENCIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91355-4457
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-284-3100
Provider Business Practice Location Address Fax Number:
661-290-3310
Provider Enumeration Date:
04/13/2015

Additional Information

Authorized Official

Authorized Official Last Name:
HALE
Authorized Official First Name:
KATHERINE
Authorized Official Middle Name:
A
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
310-301-5311

Provider Taxonomy Codes

  • Taxonomy code: 261QM1300X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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