1285728063 NPI number — HEALING HANDS

Table of content: (NPI 1285728063)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285728063 NPI number — HEALING HANDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALING HANDS
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:
1285728063
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23586 CALABASAS ROAD
Provider Second Line Business Mailing Address:
STE 206
Provider Business Mailing Address City Name:
CALABASAS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91302-1330
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-224-3837
Provider Business Mailing Address Fax Number:
818-224-3847

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23586 CALABASAS ROAD
Provider Second Line Business Practice Location Address:
SUITE 206
Provider Business Practice Location Address City Name:
CALABASAS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-224-3837
Provider Business Practice Location Address Fax Number:
818-224-3847
Provider Enumeration Date:
10/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
COOK
Authorized Official First Name:
STACY
Authorized Official Middle Name:
V
Authorized Official Title or Position:
OWNER/OCCUPATIONAL THERAPIST
Authorized Official Telephone Number:
818-224-3837

Provider Taxonomy Codes

  • Taxonomy code: 225000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X , with the licence number: 4803 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XE1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XH1200X , with the licence number: 9611000317 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XN1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: ZZZ09538Z . This is a "BLUE SHIELD GROUP PIN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 5025730001 . This is a "SUPPLIER ID" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: GCT000600 . This is a "MEDI-CAL PROVIDER NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 7611630 . This is a "AETNA PROVIDER ID" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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