1427120468 NPI number — MR. JOEL CHRISTOPHER WORK MSW

Table of content: MR. JOEL CHRISTOPHER WORK MSW (NPI 1427120468)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427120468 NPI number — MR. JOEL CHRISTOPHER WORK MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WORK
Provider First Name:
JOEL
Provider Middle Name:
CHRISTOPHER
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WORK
Provider Other First Name:
JESSE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1427120468
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19015 SUNNYSIDE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SARATOGA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95070-6242
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-395-7453
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10430 S DE ANZA BLVD STE 110
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CUPERTINO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95014-3024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-857-5731
Provider Business Practice Location Address Fax Number:
408-364-7090
Provider Enumeration Date:
11/14/2006

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: 1041C0700X , with the licence number:  LCS 15631 , 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)