1922597681 NPI number — SIERRA VIEW LOCAL HEALTH CARE DISTRICT

Table of content: DR. SANDRA V. WERNER MD (NPI 1639279656)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922597681 NPI number — SIERRA VIEW LOCAL HEALTH CARE DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SIERRA VIEW LOCAL HEALTH CARE DISTRICT
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:
1922597681
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/08/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
465 W PUTNAM AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTERVILLE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93257-3320
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-784-1110
Provider Business Mailing Address Fax Number:
559-788-6136

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19631 ROAD 224
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STRATHMORE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93267
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-784-1110
Provider Business Practice Location Address Fax Number:
559-788-6136
Provider Enumeration Date:
05/08/2018

Additional Information

Authorized Official

Authorized Official Last Name:
ZEBOSKEY
Authorized Official First Name:
DEBORAH
Authorized Official Middle Name:
K
Authorized Official Title or Position:
HIM DIRECTOR/CHIEF PRIVACY OFFICER
Authorized Official Telephone Number:
559-788-6066

Provider Taxonomy Codes

  • Taxonomy code: 261QR1300X , 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: 0 . This is a "WILL BE APPLYING FOR MEDICAID, DO NOT HAVE A NUMBER ASSIGNED AT THIS MOMENT" identifier . This identifiers is of the category "OTHER".




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