1922270305 NPI number — GOODWILL INDUSTRIES OF ORANGE COUNTY, CALIFORNIA

Table of content: (NPI 1922270305)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922270305 NPI number — GOODWILL INDUSTRIES OF ORANGE COUNTY, CALIFORNIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GOODWILL INDUSTRIES OF ORANGE COUNTY, 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:
ASSISTIVE TECHNOLOGY EXCHANGE CENTER (ATEC)
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:
1922270305
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1601 E SAINT ANDREW PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA ANA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92705-4932
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-361-6200
Provider Business Mailing Address Fax Number:
714-361-6220

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 E SAINT ANDREW PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA ANA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92705-4932
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-361-6200
Provider Business Practice Location Address Fax Number:
714-361-6220
Provider Enumeration Date:
03/26/2008

Additional Information

Authorized Official

Authorized Official Last Name:
TALARICO
Authorized Official First Name:
FRANK
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT & CEO
Authorized Official Telephone Number:
714-547-6301

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  OT7512 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X , with the licence number: SP4388 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 235Z00000X , with the licence number: SP18100 , 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)





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