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1003622259 NPI number — LATINO COMMISSION ON ALCOHOL AND DRUG ABUSE SERVICES OF SAN MATEO COUN

NPI Number: 1003622259
Health Care Provider/Practitioner: LATINO COMMISSION ON ALCOHOL AND DRUG ABUSE SERVICES OF SAN MATEO COUN

Information about “1003622259” NPI (LATINO COMMISSION ON ALCOHOL AND DRUG ABUSE SERVICES OF SAN MATEO COUN) exists in 1003622259 in HTML format HTML  |  1003622259 in plain Text format TXT  |  1003622259 in PDF (Portable Document Format) PDF  |  1003622259 in an XML format XML  formats.

NPI Number : 1003622259 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1003622259",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "LATINO COMMISSION ON ALCOHOL AND DRUG ABUSE SERVICES OF SAN MATEO COUN",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1001 SNEATH LN STE 307",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAN BRUNO",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "94066-2349",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "650-244-1444",
    "MailingAddressFaxNumber": "650-244-1447",
    "FirstLinePracticeLocationAddress": "1314 SOUTHGATE AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DALY CITY",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "94015-3937",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "650-244-1444",
    "PracticeLocationAddressFaxNumber": "650-244-1447",
    "EnumerationDate": "12/03/2024",
    "LastUpdateDate": "12/03/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BLANCAS",
    "AuthorizedOfficialFirstName": "SALVADOR",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "DIRECTOR OF SERVCES",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "650-244-1444",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "3245S0500X",
        "TaxonomyName": "Children's Substance Abuse Rehabilitation Facility",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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