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General NPI Number Information
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NPI Number | 1962874172
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Entity Type | Organization
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Legal Business Name | NAPA STATE HOSPITAL
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Dates
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Enumeration Date | 10/27/2015
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 2100 NAPA VALLEJO HWY
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City | NAPA
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State | CA
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Zip | 94558-6234
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Country | US
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Telephone | 707-815-9690
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Fax |
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Provider Business Mailing Address
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Address Line | 1684 PEAR TREE LN
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City | NAPA
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State | CA
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Zip | 94558-6487
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Country | US
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Telephone | 707-815-9690
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Fax |
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Authorized Official
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Title or Position | PHARMACIST I
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Name | MR. JOHN BOLING
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Credential | RPH
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Telephone | 707-253-5264
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 36253
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License Number State | CA
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