1730394834 NPI number — OASIS CARE, INC.

Table of content: (NPI 1730394834)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730394834 NPI number — OASIS CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OASIS CARE, INC.
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:
6
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:
1730394834
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
02/07/2011
NPI Reactivation Date:
03/21/2011

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 JOSE FIGUERES AVE
Provider Second Line Business Mailing Address:
(FORMERLY P.O. BOX 2260, SANJOSE 95109)
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95116
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-347-3120
Provider Business Mailing Address Fax Number:
408-347-3121

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 JOSE FIGUERES AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-347-3120
Provider Business Practice Location Address Fax Number:
408-347-3121
Provider Enumeration Date:
05/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WATERS
Authorized Official First Name:
CATHRYN
Authorized Official Middle Name:
Authorized Official Title or Position:
CLINICAL DIRECTOR
Authorized Official Telephone Number:
408-347-3104

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 320800000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: C2344925 . This is a "CA CORP #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 47711791 . This is a "EDD #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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