1326494469 NPI number — JENNIFER ESTHER YURIAR N.P.A

Table of content: JENNIFER ESTHER YURIAR N.P.A (NPI 1326494469)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326494469 NPI number — JENNIFER ESTHER YURIAR N.P.A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YURIAR
Provider First Name:
JENNIFER
Provider Middle Name:
ESTHER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
N.P.A
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OTERO
Provider Other First Name:
JENNIFER
Provider Other Middle Name:
ESTHER
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1326494469
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/16/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
370 HENDERSON DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95123-4413
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-759-0312
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7475 CAMINO ARROYO
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GILROY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95020-7348
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-852-2209
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/08/2016

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: 363LF0000X , with the licence number:  95003498 , 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)