Provider Demographics
NPI:1144777921
Name:FOSTER FOUNDATION
Entity Type:Organization
Organization Name:FOSTER FOUNDATION
Other - Org Name:FOSTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CHAIRMAN OF THE BOARD/S
Authorized Official - Prefix:
Authorized Official - First Name:PRINCESS LEIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-349-8384
Mailing Address - Street 1:PO BOX 8231
Mailing Address - Street 2:1050 SHELL BLVD.
Mailing Address - City:FOSTER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94404-8231
Mailing Address - Country:US
Mailing Address - Phone:650-349-8384
Mailing Address - Fax:
Practice Address - Street 1:1050 SHELL BLVD
Practice Address - Street 2:
Practice Address - City:FOSTER CITY
Practice Address - State:CA
Practice Address - Zip Code:94404-2983
Practice Address - Country:US
Practice Address - Phone:650-349-8384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FOSTER (PART OF THE PRINCESS LEIA LUCAS FOUNDATIONS)
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty