1811902232 NPI number — DR. JOSEPH RONALD GIALLO ED.D

Table of content: DR. JOSEPH RONALD GIALLO ED.D (NPI 1811902232)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811902232 NPI number — DR. JOSEPH RONALD GIALLO ED.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GIALLO
Provider First Name:
JOSEPH
Provider Middle Name:
RONALD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
ED.D
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GIALLO
Provider Other First Name:
JOSEPH
Provider Other Middle Name:
RONALD
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
ED.D
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1811902232
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/06/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
820 BAY AVE
Provider Second Line Business Mailing Address:
208
Provider Business Mailing Address City Name:
CAPITOLA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95010-2140
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
831-475-1323
Provider Business Mailing Address Fax Number:
831-477-2034

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
820 BAY AVE
Provider Second Line Business Practice Location Address:
208A
Provider Business Practice Location Address City Name:
CAPITOLA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95010-2140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-475-1323
Provider Business Practice Location Address Fax Number:
831-477-2034
Provider Enumeration Date:
07/31/2006

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: 103G00000X , with the licence number:  PSY15522 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103TC0700X , with the licence number: PSY15522 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TF0200X , with the licence number: PSY15522 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TR0400X , with the licence number: PSY15522 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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