1952816274 NPI number — BUILD LEARN THRIVE, PC

Table of content: (NPI 1952816274)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952816274 NPI number — BUILD LEARN THRIVE, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BUILD LEARN THRIVE, PC
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:
1952816274
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/26/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
945 TARAVAL ST # 204
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94116-2422
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-930-5860
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2211 POST ST STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94115-3442
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-930-5860
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/08/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CONNOLLY
Authorized Official First Name:
MEILANI
Authorized Official Middle Name:
Authorized Official Title or Position:
FOUNDER
Authorized Official Telephone Number:
408-930-5860

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X , with the licence number: 3625 , 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: 22969 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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