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General NPI Number Information
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NPI Number | 1790051035
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Entity Type | Organization
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Legal Business Name | KAISER PERMANENTE
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Dates
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Enumeration Date | 03/30/2012
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Last Update Date | 03/30/2012
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Provider Practice Location Address
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Address Line | 1617 BROADWAY ST
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City | VALLEJO
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State | CA
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Zip | 94590-2406
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Country | US
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Telephone | 707-556-3929
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Fax |
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Provider Business Mailing Address
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Address Line | 600 SUNTREE LN
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City | PLEASANT HILL
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State | CA
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Zip | 94523-5183
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Country | US
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Telephone | 925-363-4962
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Fax |
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Authorized Official
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Title or Position | WELLNESS COACH
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Name | ROBIN E BJORGER
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Credential |
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Telephone | 707-523-3929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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