1093083529 NPI number — MRS. KRISTINE MICHELE AUGUSTA MSW

Table of content: MRS. KRISTINE MICHELE AUGUSTA MSW (NPI 1093083529)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093083529 NPI number — MRS. KRISTINE MICHELE AUGUSTA MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AUGUSTA
Provider First Name:
KRISTINE
Provider Middle Name:
MICHELE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MUELLER
Provider Other First Name:
KRISTINE
Provider Other Middle Name:
MICHELE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1093083529
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/12/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
124 RIVER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALINAS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93908-9601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-440-1090
Provider Business Mailing Address Fax Number:
831-455-4789

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
124 RIVER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALINAS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93908-9601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-440-1090
Provider Business Practice Location Address Fax Number:
831-455-4789
Provider Enumeration Date:
12/12/2011

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: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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