1265504047 NPI number — S O S INTERNATIONAL INC

Table of content: MS. JACQUELINE ANN STREIFF RN (NPI 1609371665)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265504047 NPI number — S O S INTERNATIONAL INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
S O S INTERNATIONAL 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:
1265504047
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/23/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2196 SAVIERS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OXNARD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93033-3825
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-487-6303
Provider Business Mailing Address Fax Number:
805-486-4295

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2196 SAVIERS RD
Provider Second Line Business Practice Location Address:
MISSION VILLAGE SHOPPING CENTER
Provider Business Practice Location Address City Name:
OXNARD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-487-6303
Provider Business Practice Location Address Fax Number:
805-486-4295
Provider Enumeration Date:
11/15/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RAMINANI
Authorized Official First Name:
RAMESH
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
805-487-6303

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336L0003X , with the licence number: PHY41178 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PHY41178 , 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: PHY411780 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0570615 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".