Provider Demographics
NPI:1902415540
Name:WORLD TREKKER LLC
Entity Type:Organization
Organization Name:WORLD TREKKER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:BRINA
Authorized Official - Middle Name:AI
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:408-449-1876
Mailing Address - Street 1:2756 WHITE ACRES DRIVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148
Mailing Address - Country:US
Mailing Address - Phone:408-449-1876
Mailing Address - Fax:
Practice Address - Street 1:2756 WHITE ACRES DRIVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148
Practice Address - Country:US
Practice Address - Phone:408-449-1876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health