1427133610 NPI number — MS. MEREDITH RING CRAIG MFT

Table of content: MS. MEREDITH RING CRAIG MFT (NPI 1427133610)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427133610 NPI number — MS. MEREDITH RING CRAIG MFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRAIG
Provider First Name:
MEREDITH
Provider Middle Name:
RING
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CRAIG
Provider Other First Name:
MEREDITH
Provider Other Middle Name:
RING
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:
1427133610
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3616 ARIZONA ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92104-4014
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
858-752-0546
Provider Business Mailing Address Fax Number:
858-720-9066

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3616 ARIZONA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92104-4014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-752-0546
Provider Business Practice Location Address Fax Number:
858-752-0546
Provider Enumeration Date:
10/26/2006

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: 106H00000X , with the licence number:  MFT41354 , 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: MFT41354 . This is a "LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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