1982945689 NPI number — LEMON HEIGHTS HOLDINGS INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982945689 NPI number — LEMON HEIGHTS HOLDINGS INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LEMON HEIGHTS HOLDINGS INC.
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:
1982945689
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/06/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2089
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARTESIA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90702-2089
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-860-2210
Provider Business Mailing Address Fax Number:
714-940-0941

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17215 STUDEBAKER ROAD
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
CERRITOS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90703-2521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-860-2210
Provider Business Practice Location Address Fax Number:
562-860-1154
Provider Enumeration Date:
03/06/2013

Additional Information

Authorized Official

Authorized Official Last Name:
JOHANSEN
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
NILS
Authorized Official Title or Position:
OWNER-OFFICER
Authorized Official Telephone Number:
562-860-2210

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  PSY10129 , 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: PSY101290 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com