1730158676 NPI number — MS. JILLAINE ANN SOCHA P.A.- C

Table of content: MS. JILLAINE ANN SOCHA P.A.- C (NPI 1730158676)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730158676 NPI number — MS. JILLAINE ANN SOCHA P.A.- C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOCHA
Provider First Name:
JILLAINE
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
P.A.- C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WADIN
Provider Other First Name:
JILL
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
P.A.- C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730158676
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/19/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1260 S MAIN ST
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
SALINAS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93901-2288
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
831-769-9355
Provider Business Mailing Address Fax Number:
831-754-4955

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
230 SAN JOSE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALINAS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93901-3901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-758-2100
Provider Business Practice Location Address Fax Number:
831-758-1565
Provider Enumeration Date:
03/14/2006

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: 363AM0700X , with the licence number:  PA11365 , 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)

  • Identifier: 1912919804 . This is a "NPI - TYPE 2" identifier . This identifiers is of the category "OTHER".
  • Identifier: W1514B . This is a "MEDICARE PTAN - TYPE 2" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 970013835 . This is a "RAIL ROAD MEDICARE - PROVIDER PTAN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: CG5665 . This is a "RAIL ROAD MEDICARE - GROUP PTAN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: W1514 . This is a "MEDICARE PTAN - TYPE 2" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1447410519 . This is a "NPI - TYPE 2" identifier . This identifiers is of the category "OTHER".
  • Identifier: W11996 . This is a "MEDICARE PTAN - TYPE 2" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1720247455 . This is a "NPI - TYPE 2" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com