1942404512 NPI number — DR. SILVINA SOLEDAD HOLASEK MD

Table of content: DR. SILVINA SOLEDAD HOLASEK MD (NPI 1942404512)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942404512 NPI number — DR. SILVINA SOLEDAD HOLASEK MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOLASEK
Provider First Name:
SILVINA
Provider Middle Name:
SOLEDAD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1942404512
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/28/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2100 NAPA VALLEJO HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NAPA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94558-6293
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
707-253-5000
Provider Business Mailing Address Fax Number:
707-671-7789

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
206 MASON ST STE F
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UKIAH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95482-4494
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-671-7788
Provider Business Practice Location Address Fax Number:
707-671-7789
Provider Enumeration Date:
06/14/2007

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: 2084P0804X , with the licence number:  A106552 , 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)

  • Identifier: 2804684516 . This is a "MYUTMB 2804684516-COMMERCIAL NUMBER" identifier . This identifiers is of the category "OTHER".




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