Provider Demographics
NPI:1437747557
Name:VA PALO ALTO HEALTH CARE SYSTEM
Entity Type:Organization
Organization Name:VA PALO ALTO HEALTH CARE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISORY SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:BUELNA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:650-690-5009
Mailing Address - Street 1:5585 SILVER CREEK VALLEY PLACE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95138
Mailing Address - Country:US
Mailing Address - Phone:650-690-5009
Mailing Address - Fax:
Practice Address - Street 1:7777 SOUTH FREEDOM RD
Practice Address - Street 2:TRAILER S-1, ROOM 106
Practice Address - City:FRENCH CAMP
Practice Address - State:CA
Practice Address - Zip Code:95231
Practice Address - Country:US
Practice Address - Phone:209-946-3400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAASW81263OtherBBS