Provider Demographics
NPI:1407885288
Name:SUTTER VISITING NURSE ASSOCIATION AND HOSPICE
Entity Type:Organization
Organization Name:SUTTER VISITING NURSE ASSOCIATION AND HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:LINTON
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE, JR.
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-450-8521
Mailing Address - Street 1:1651 ALVARADO ST
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-2636
Mailing Address - Country:US
Mailing Address - Phone:510-618-5277
Mailing Address - Fax:510-347-6866
Practice Address - Street 1:1651 ALVARADO ST
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-2636
Practice Address - Country:US
Practice Address - Phone:510-618-5277
Practice Address - Fax:510-347-6866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05-7004Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER