1053345876 NPI number — SUTTER VISITING NURSE ASSOCIATION AND HOSPICE

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 1053345876 NPI number — SUTTER VISITING NURSE ASSOCIATION AND HOSPICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUTTER VISITING NURSE ASSOCIATION AND HOSPICE
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:
1053345876
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/07/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4600 S TRACY BLVD
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
TRACY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95377-8105
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
209-830-5300
Provider Business Mailing Address Fax Number:
209-832-2193

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4600 S TRACY BLVD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
TRACY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95377-8105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-830-5300
Provider Business Practice Location Address Fax Number:
209-832-2193
Provider Enumeration Date:
07/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ADAMS
Authorized Official First Name:
PAULA
Authorized Official Middle Name:
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
916-614-1411

Provider Taxonomy Codes

  • Taxonomy code: 251J00000X , 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)





Copyright © 2007-2025 www.npivalidator.com