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General NPI Number Information
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NPI Number | 1649434812
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Entity Type | Organization
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Legal Business Name | ACHIEVEKIDS
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Dates
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Enumeration Date | 07/16/2008
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 3860 MIDDLEFIELD RD
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City | PALO ALTO
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State | CA
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Zip | 94303-4716
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Country | US
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Telephone | 650-494-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 3860 MIDDLEFIELD ROAD
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City | PALO ALTO
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State | CA
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Zip | 94303
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Country | US
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Telephone | 650-494-1200
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Fax |
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Authorized Official
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Title or Position | TRAINEE
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Name | MISS LIEZL TORREFIEL
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Credential |
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Telephone | 650-494-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 106H0000X
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License Number State | CA
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