1902318025 NPI number — ROSANDA J ANDERSON LLC

Table of content: (NPI 1902318025)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902318025 NPI number — ROSANDA J ANDERSON LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROSANDA J ANDERSON LLC
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:
AGING AND ADULT RESOURCES AND PLACEMENTS
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:
1902318025
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/11/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4509 FOXBORO AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAKERSFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93309-5812
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-472-4431
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4509 FOXBORO AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-5812
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-472-4431
Provider Business Practice Location Address Fax Number:
800-691-9109
Provider Enumeration Date:
10/30/2017

Additional Information

Authorized Official

Authorized Official Last Name:
ANDERSON
Authorized Official First Name:
ROSANDA
Authorized Official Middle Name:
JENAY
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
661-472-4431

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251E00000X , 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)





Copyright © 2007-2024 www.npivalidator.com