1518192962 NPI number — MS. KARLA ELIZABETE CAMPBELL MS, RD, CSSD

Table of content: MS. KARLA ELIZABETE CAMPBELL MS, RD, CSSD (NPI 1518192962)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518192962 NPI number — MS. KARLA ELIZABETE CAMPBELL MS, RD, CSSD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAMPBELL
Provider First Name:
KARLA
Provider Middle Name:
ELIZABETE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS, RD, CSSD
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:
1518192962
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/28/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3701 BIRCH ST
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
NEWPORT BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92660-2618
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-722-7662
Provider Business Mailing Address Fax Number:
949-631-6585

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3701 BIRCH ST
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
NEWPORT BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92660-2618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-722-7662
Provider Business Practice Location Address Fax Number:
949-631-6585
Provider Enumeration Date:
05/28/2009

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: 133V00000X , with the licence number:  948990 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com