1841357233 NPI number — CALIFORNIA PHYSICAL, OCCUPATIONAL, SPEECH AND HAND THERAPY, INC.

Table of content: (NPI 1841357233)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841357233 NPI number — CALIFORNIA PHYSICAL, OCCUPATIONAL, SPEECH AND HAND THERAPY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CALIFORNIA PHYSICAL, OCCUPATIONAL, SPEECH AND HAND THERAPY, INC.
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:
CALIFORNIA REHABILITTION
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:
1841357233
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/10/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1539 MCHENRY AVE STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MODESTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95350-4528
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
209-578-3290
Provider Business Mailing Address Fax Number:
209-529-8643

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1539 MCHENRY AVE
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
MODESTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95350-4528
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-578-3290
Provider Business Practice Location Address Fax Number:
209-529-8643
Provider Enumeration Date:
01/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
STECKLER
Authorized Official First Name:
JEFF
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER PRESIDENT
Authorized Official Telephone Number:
209-578-3290

Provider Taxonomy Codes

  • Taxonomy code: 224Z00000X , with the licence number:  0161717 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 0161717 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251C2600X , with the licence number: 0161717 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251E1200X , with the licence number: 0161717 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251E1300X , with the licence number: 0161717 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251G0304X , with the licence number: 0161717 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251N0400X , with the licence number: 0161717 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251P0200X , with the licence number: 0161717 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251S0007X , with the licence number: 0161717 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225200000X , with the licence number: 0161717 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X , with the licence number: 0161717 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XE1200X , with the licence number: 0161717 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XH1200X , with the licence number: 0161717 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XN1300X , with the licence number: 0161717 , 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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