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General NPI Number Information
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NPI Number | 1154500965
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Entity Type | Organization
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Legal Business Name | JA.CORP
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Dates
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Enumeration Date | 10/29/2007
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Last Update Date | 09/07/2011
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Provider Practice Location Address
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Address Line | 791 EAST ST
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City | WOODLAND
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State | CA
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Zip | 95776-4144
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Country | US
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Telephone | 530-415-8118
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Fax | 530-668-8949
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Provider Business Mailing Address
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Address Line | PO BOX 1162
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City | WOODLAND
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State | CA
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Zip | 95776-1162
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Country | US
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Telephone | 530-402-1510
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Fax | 530-668-8949
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Authorized Official
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Title or Position | PRESIDENT
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Name | JESUS CACHURIOS
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Credential |
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Telephone | 530-402-1510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | TD2007-11
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License Number State | CA
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