1952576746 NPI number — MS. CATHERINE M INTRAVIA SUDCC III-CS #6319

Table of content: MS. CATHERINE M INTRAVIA SUDCC III-CS #6319 (NPI 1952576746)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952576746 NPI number — MS. CATHERINE M INTRAVIA SUDCC III-CS #6319

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
INTRAVIA
Provider First Name:
CATHERINE
Provider Middle Name:
M
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
SUDCC III-CS #6319
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
INTRAVIA
Provider Other First Name:
CATHERINE
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
SUDCC III-CS #6319
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1952576746
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/12/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16433 MONTEREY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORGAN HILL
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95037-7168
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-782-6300
Provider Business Mailing Address Fax Number:
408-782-6363

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16433 MONTEREY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORGAN HILL
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95037-7168
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-782-6300
Provider Business Practice Location Address Fax Number:
408-782-6363
Provider Enumeration Date:
04/23/2008

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: 101YA0400X , with the licence number:  6319 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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