Healthcare Provider Details

I. General information

NPI: 1962401877
Provider Name (Legal Business Name): STINSON BEACH FIRE PROTECTION DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 09/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 HIGHWAY 1
STINSON BEACH CA
94970
US

IV. Provider business mailing address

PO BOX 127
STINSON BEACH CA
94970-0127
US

V. Phone/Fax

Practice location:
  • Phone: 415-868-0622
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: KENNY STEVENS
Title or Position: FIRE CHIEF
Credential:
Phone: 415-868-0622