1518036383 NPI number — MRS. KRISTINA AOALIN

Table of content: MRS. KRISTINA AOALIN (NPI 1518036383)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518036383 NPI number — MRS. KRISTINA AOALIN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AOALIN
Provider First Name:
KRISTINA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
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:
ROOT
Provider Other First Name:
KRISTINA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1518036383
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/20/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
843 WHITEFIR LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95133-1235
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-806-7171
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
299 S CALIFORNIA AVE STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PALO ALTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94306-1915
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-331-3700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/07/2006

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: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 32558 . This is a "LICENSE#" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".