1457832206 NPI number — ANITA MARIA SOLIS SCHOOL NURSE

Table of content: ANITA MARIA SOLIS SCHOOL NURSE (NPI 1457832206)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457832206 NPI number — ANITA MARIA SOLIS SCHOOL NURSE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOLIS
Provider First Name:
ANITA
Provider Middle Name:
MARIA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
SCHOOL NURSE
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:
1457832206
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/28/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
62 S OLIVE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEMOORE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93245-3410
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-381-6543
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1520 PATTERSON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORCORAN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93212-1722
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-992-8880
Provider Business Practice Location Address Fax Number:
559-992-3957
Provider Enumeration Date:
08/28/2018

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: 163WS0200X , with the licence number:  489707 , 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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