1942979182 NPI number — HOSPITAL SAN JOSE SA

Table of content: JENNIFER DENISE MORRISON M.D. (NPI 1720026099)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942979182 NPI number — HOSPITAL SAN JOSE SA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOSPITAL SAN JOSE SA
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:
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:
1942979182
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/10/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2600 DALLAS PKWY
Provider Second Line Business Mailing Address:
SUITE 350
Provider Business Mailing Address City Name:
FRISCO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75034
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-731-1767
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 METROS AL ESTE DEL CENTRO COMERCIAL MULTIPLAZA
Provider Second Line Business Practice Location Address:
AUTOPISTA PROSPERO FERNANDEZ
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
SAN RAFAEL
Provider Business Practice Location Address Postal Code:
10201
Provider Business Practice Location Address Country Code:
CR
Provider Business Practice Location Address Telephone Number:
855-782-6253
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/10/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MAIR
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
LESLIE
Authorized Official Title or Position:
SENIOR VICE PRESIDENT
Authorized Official Telephone Number:
469-731-1767

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QC0050X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336I0012X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)