Healthcare Provider Details

I. General information

NPI: 1437789401
Provider Name (Legal Business Name): GENEVA HALL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2020
Last Update Date: 01/18/2020
Certification Date: 01/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 W FRANKLIN ST STE 202
MONTEREY CA
93940-2725
US

IV. Provider business mailing address

316 MID VALLEY CTR # 186
CARMEL CA
93923-8516
US

V. Phone/Fax

Practice location:
  • Phone: 800-991-6071
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: