Provider Demographics
NPI:1053475905
Name:NORTH STAR EMERGENCY SERVICES, INC.
Entity Type:Organization
Organization Name:NORTH STAR EMERGENCY SERVICES, INC.
Other - Org Name:NORCAL AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO AND FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAZARENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-487-9642
Mailing Address - Street 1:PO BOX 12347
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-2347
Mailing Address - Country:US
Mailing Address - Phone:925-452-8300
Mailing Address - Fax:
Practice Address - Street 1:3174 CONSTITUTION DR
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94551-7570
Practice Address - Country:US
Practice Address - Phone:925-452-8300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1880341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTE01183FMedicaid
CA=========OtherGENERIC HMO PROVIDER NUMB
CAZZZ01850ZMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CA=========OtherGENERIC HMO PROVIDER NUMB