1639213127 NPI number — ASPIRA FOSTER & FAMILY SERVICES - NORTH LA

Table of content: MS. ELIZABETH ANN WATSON RN PNP (NPI 1528443603)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639213127 NPI number — ASPIRA FOSTER & FAMILY SERVICES - NORTH LA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASPIRA FOSTER & FAMILY SERVICES - NORTH LA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1639213127
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/27/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15650 DEVONSHIRE ST
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
GRANADA HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91344-7241
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-830-6190
Provider Business Mailing Address Fax Number:
818-830-6182

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15650 DEVONSHIRE ST
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
GRANADA HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91344-7241
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-830-6190
Provider Business Practice Location Address Fax Number:
818-830-6182
Provider Enumeration Date:
02/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
VERNON
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
650-866-4080

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , 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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