1992571954 NPI number — COMMUNITY PSYCH NURSING PARTNERS INC

Table of content: MATTHEW MASON CARTER MD (NPI 1467346304)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992571954 NPI number — COMMUNITY PSYCH NURSING PARTNERS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY PSYCH NURSING PARTNERS 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:
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:
1992571954
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/18/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 12269
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97212-0269
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-542-2253
Provider Business Mailing Address Fax Number:
619-334-3765

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7050 PARKWAY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LA MESA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91942-1535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-542-2253
Provider Business Practice Location Address Fax Number:
619-334-3765
Provider Enumeration Date:
11/30/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HAYNES
Authorized Official First Name:
ANNA
Authorized Official Middle Name:
JOY
Authorized Official Title or Position:
CONTROLLER
Authorized Official Telephone Number:
503-542-2253

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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