1770752792 NPI number — MRS. JANINA CECILIA SUNDERHAUS AS

Table of content: MRS. JANINA CECILIA SUNDERHAUS AS (NPI 1770752792)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770752792 NPI number — MRS. JANINA CECILIA SUNDERHAUS AS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SUNDERHAUS
Provider First Name:
JANINA
Provider Middle Name:
CECILIA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
AS
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:
1770752792
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
426 BARCELLUS AVE
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
SANTA MARIA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93454-6925
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-347-4444
Provider Business Mailing Address Fax Number:
805-347-4446

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
426 BARCELLUS AVE
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
SANTA MARIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93454-6925
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-347-4444
Provider Business Practice Location Address Fax Number:
805-347-4446
Provider Enumeration Date:
02/23/2008

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: 126800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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