Provider Demographics
NPI:1326318726
Name:FIRSTAT NURSING SERVICES INC.
Entity Type:Organization
Organization Name:FIRSTAT NURSING SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINNEA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GOODRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-220-7600
Mailing Address - Street 1:411 CAMINO DEL RIO S
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3530
Mailing Address - Country:US
Mailing Address - Phone:619-220-7600
Mailing Address - Fax:619-220-7607
Practice Address - Street 1:411 CAMINO DEL RIO S
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3530
Practice Address - Country:US
Practice Address - Phone:619-220-7600
Practice Address - Fax:619-220-7607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA080000580251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA080000580OtherSTATE OF CALIFORNIA DEPARTMENT OF PUBLIC HEALTH