1407307184 NPI number — KRISTA HAUNANI FRANCISCO ATC

Table of content: KRISTA HAUNANI FRANCISCO ATC (NPI 1407307184)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407307184 NPI number — KRISTA HAUNANI FRANCISCO ATC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRANCISCO
Provider First Name:
KRISTA
Provider Middle Name:
HAUNANI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ATC
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:
1407307184
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/18/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2030 S TREMONT ST
Provider Second Line Business Mailing Address:
APT 20
Provider Business Mailing Address City Name:
OCEANSIDE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92054
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-952-0896
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2030 S TREMONT ST
Provider Second Line Business Practice Location Address:
APT 20
Provider Business Practice Location Address City Name:
OCEANSIDE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92054-6537
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-952-0896
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/18/2016

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: 2255A2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2000002375 . This is a "BOC CERTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".




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