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General NPI Number Information
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NPI Number | 1992389837
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Entity Type | Organization
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Legal Business Name | STANDARD BEARER CONSULTING LLC
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Dates
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Enumeration Date | 05/06/2021
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Last Update Date | 05/06/2021
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Provider Practice Location Address
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Address Line | 1730 S AMPHLETT BLVD STE 107
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City | SAN MATEO
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State | CA
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Zip | 94402-2709
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Country | US
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Telephone | 650-844-7442
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Fax | 650-523-4444
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Provider Business Mailing Address
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Address Line | 1730 S AMPHLETT BLVD STE 107
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City | SAN MATEO
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State | CA
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Zip | 94402-2709
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Country | US
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Telephone | 650-844-7442
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Fax | 650-523-4444
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | BONN ANTHONY CERVANTES PAJE
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Credential | CERTIFIED CONSULTANT
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Telephone | 415-715-4646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care 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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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