1073316824 NPI number — JANE F SMITH PPS SCHOOL COUNSELOR

Table of content: JANE F SMITH PPS SCHOOL COUNSELOR (NPI 1073316824)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073316824 NPI number — JANE F SMITH PPS SCHOOL COUNSELOR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SMITH
Provider First Name:
JANE
Provider Middle Name:
F
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PPS SCHOOL COUNSELOR
Provider Gender Code:
F

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:
1073316824
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/28/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2001 TAVERN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALPINE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91901-3129
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
619-445-8676
Provider Business Mailing Address Fax Number:
619-445-1420

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2320 TAVERN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALPINE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91901-3134
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-445-8676
Provider Business Practice Location Address Fax Number:
619-445-1420
Provider Enumeration Date:
03/28/2025

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: 101YS0200X , 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