1538450127 NPI number — MRS. SARAH ELIZABETH WENZEL C.P.O.

Table of content: MRS. SARAH ELIZABETH WENZEL C.P.O. (NPI 1538450127)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538450127 NPI number — MRS. SARAH ELIZABETH WENZEL C.P.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WENZEL
Provider First Name:
SARAH
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
C.P.O.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CARR
Provider Other First Name:
SARAH
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
C.P.O.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1538450127
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/11/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
88 ROWLAND WAY
Provider Second Line Business Mailing Address:
SUITE 175
Provider Business Mailing Address City Name:
NOVATO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94945-5042
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-892-1502
Provider Business Mailing Address Fax Number:
415-892-1907

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
88 ROWLAND WAY
Provider Second Line Business Practice Location Address:
SUITE 175
Provider Business Practice Location Address City Name:
NOVATO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94945-5042
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-892-1502
Provider Business Practice Location Address Fax Number:
415-892-1907
Provider Enumeration Date:
04/29/2011

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: 222Z00000X , with the licence number:  OI60223048 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 224P00000X , with the licence number: PS60223055 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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