1497297170 NPI number — CHRISTINE HIRABAYASHI

Table of content: CHRISTINE HIRABAYASHI (NPI 1497297170)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497297170 NPI number — CHRISTINE HIRABAYASHI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HIRABAYASHI
Provider First Name:
CHRISTINE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
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:
1497297170
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/10/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1221 BLACKBERRY TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUNNYVALE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94087-2064
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-981-0543
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15047 LOS GATOS BLVD STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS GATOS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95032-2054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-364-6799
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/10/2016

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: 106H00000X , with the licence number:  LMFT93623 , 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)