1366570038 NPI number — COUNTY OF MONTEREY

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 1366570038 NPI number — COUNTY OF MONTEREY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF MONTEREY
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:
6
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:
1366570038
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/11/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1441 SCHILLING PLACE
Provider Second Line Business Mailing Address:
SOUTH BLDG - FIRST FLOOR - HEALTH DEPT CLINIC SERVICES
Provider Business Mailing Address City Name:
SALINAS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93901-4527
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
831-769-8800
Provider Business Mailing Address Fax Number:
831-422-9312

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1441 CONSTITUTION BLVD
Provider Second Line Business Practice Location Address:
BLDG. 200, SUITE 105
Provider Business Practice Location Address City Name:
SALINAS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93906-3100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-769-8640
Provider Business Practice Location Address Fax Number:
831-769-8632
Provider Enumeration Date:
03/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
EDGCOMB
Authorized Official First Name:
JULIA
Authorized Official Middle Name:
CLAIRE
Authorized Official Title or Position:
DIRECTOR/COO CLINIC SERVICES DIV
Authorized Official Telephone Number:
831-769-6522

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , 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: FHC70124F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: HAP70124F . This is a "COUNTY OF MONTEREY FAMPAC" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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