1942418082 NPI number — MR. WILLIAM MORRISE RIGOLE SR. LICENSED CLINICAL SO

Table of content: MR. WILLIAM MORRISE RIGOLE SR. LICENSED CLINICAL SO (NPI 1942418082)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942418082 NPI number — MR. WILLIAM MORRISE RIGOLE SR. LICENSED CLINICAL SO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIGOLE
Provider First Name:
WILLIAM
Provider Middle Name:
MORRISE
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
SR.
Provider Credential Text:
LICENSED CLINICAL SO
Provider Gender Code:
M

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:
1942418082
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 E VETERANS PARKWAY
Provider Second Line Business Mailing Address:
VETERANS HOME OF CA BARSTOW
Provider Business Mailing Address City Name:
BARSTOW
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92311
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 E VETERANS PARKWAY
Provider Second Line Business Practice Location Address:
VETERANS HOME OF CA BARSTOW
Provider Business Practice Location Address City Name:
BARSTOW
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92311
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-252-6241
Provider Business Practice Location Address Fax Number:
760-252-6248
Provider Enumeration Date:
05/21/2007

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: 1041C0700X , with the licence number:  LCS 15714 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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