1952552473 NPI number — LINA ASSAD CATES NCC

Table of content: LINA ASSAD CATES NCC (NPI 1952552473)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952552473 NPI number — LINA ASSAD CATES NCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CATES
Provider First Name:
LINA
Provider Middle Name:
ASSAD
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ASSAD
Provider Other First Name:
LINA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MFT INTERN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1952552473
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/22/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3800 COOLIDGE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAKLAND
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94602-3311
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-482-2244
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3800 COOLIDGE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94602-3311
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-482-2244
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/02/2008

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: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 421504 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".