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General NPI Number Information
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NPI Number | 1124347000
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Entity Type | Organization
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Legal Business Name | EASTER SEALS NORTHERN CALIFORNIA
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Dates
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Enumeration Date | 05/18/2010
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Last Update Date | 05/18/2010
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Provider Practice Location Address
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Address Line | 20 PIMENTEL CT STE A1
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City | NOVATO
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State | CA
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Zip | 94949-5656
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Country | US
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Telephone | 415-382-7450
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Fax | 415-385-7457
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Provider Business Mailing Address
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Address Line | 20 PIMENTEL CT STE A1
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City | NOVATO
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State | CA
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Zip | 94949-5656
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Country | US
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Telephone | 415-382-7450
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Fax | 415-385-7457
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Authorized Official
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Title or Position | DIRECTOR, ACCOUNTING & HUMAN RESOUR
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Name | MARY MARGARET O'BRIEN
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Credential |
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Telephone | 415-382-7450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number |
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License Number State |
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