1508988809 NPI number — MR. TODD MICHAEL FIORI MFT, PPS

Table of content: MR. TODD MICHAEL FIORI MFT, PPS (NPI 1508988809)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508988809 NPI number — MR. TODD MICHAEL FIORI MFT, PPS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FIORI
Provider First Name:
TODD
Provider Middle Name:
MICHAEL
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MFT, PPS
Provider Gender Code:
M

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:
1508988809
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:
1660 UNION SQUARE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST SACRAMENTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95691-5178
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-752-0309
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1020 SUNDOWN WAY, SUITE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROSEVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95661-4473
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-784-6102
Provider Business Practice Location Address Fax Number:
916-784-6170
Provider Enumeration Date:
04/06/2007

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:  MFC 39013 , 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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