1871615666 NPI number — PATRICIA L VINCENT R.D.

Table of content: PATRICIA L VINCENT R.D. (NPI 1871615666)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871615666 NPI number — PATRICIA L VINCENT R.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VINCENT
Provider First Name:
PATRICIA
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
R.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VINCENT
Provider Other First Name:
TRICIA
Provider Other Middle Name:
L
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
R.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1871615666
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P O BOX HH
Provider Second Line Business Mailing Address:
BUSINESS DEVELOPMENT & CONTRACTING
Provider Business Mailing Address City Name:
MONTEREY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93940
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
831-622-2716
Provider Business Mailing Address Fax Number:
831-625-4764

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23625 HOLMAN HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONTEREY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93940-5902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-624-5311
Provider Business Practice Location Address Fax Number:
831-625-4948
Provider Enumeration Date:
04/04/2007

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: 133V00000X , with the licence number:  848312 , 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)