1447531801 NPI number — MR. JESUS MAURICIO ALFARO JR. RN,MSN,ACNP-BC

Table of content: MR. JESUS MAURICIO ALFARO JR. RN,MSN,ACNP-BC (NPI 1447531801)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447531801 NPI number — MR. JESUS MAURICIO ALFARO JR. RN,MSN,ACNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALFARO
Provider First Name:
JESUS
Provider Middle Name:
MAURICIO
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
RN,MSN,ACNP-BC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALFARO
Provider Other First Name:
JESSE
Provider Other Middle Name:
MAURICIO
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
JR.
Provider Other Credential Text:
RN,MSN,ACNP-BC
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1447531801
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/30/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
227 HILLCREST DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALY CITY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94014-1028
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-438-9251
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 PASTEUR DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STANFORD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94305-2200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-498-3333
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/30/2011

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: 363LA2100X , with the licence number:  20433 , 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)





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