Provider Demographics
NPI:1699663732
Name:NAVVISA, INC.
Entity type:Organization
Organization Name:NAVVISA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:STINEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-390-6948
Mailing Address - Street 1:3372 WOODSIDE RD
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:94062-3638
Mailing Address - Country:US
Mailing Address - Phone:844-628-8472
Mailing Address - Fax:
Practice Address - Street 1:3372 WOODSIDE RD
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:CA
Practice Address - Zip Code:94062-3638
Practice Address - Country:US
Practice Address - Phone:844-628-8472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center