1851812242 NPI number — REDEFINING YOU THERAPY, INCORPORATED

Table of content: (NPI 1851812242)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851812242 NPI number — REDEFINING YOU THERAPY, INCORPORATED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REDEFINING YOU THERAPY, INCORPORATED
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:
1851812242
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3105 1ST AVENUE, SUITE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SACRAMENTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95817
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-956-6232
Provider Business Mailing Address Fax Number:
916-476-3464

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3105 1ST AVE STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95817-1914
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-956-6232
Provider Business Practice Location Address Fax Number:
916-476-3464
Provider Enumeration Date:
07/06/2017

Additional Information

Authorized Official

Authorized Official Last Name:
ADAMS-BEST
Authorized Official First Name:
OLA
Authorized Official Middle Name:
RENEE
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
916-956-6232

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)





Copyright © 2007-2025 www.npivalidator.com