Provider Demographics
NPI:1992389837
Name:STANDARD BEARER CONSULTING LLC
Entity Type:Organization
Organization Name:STANDARD BEARER CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BONN ANTHONY
Authorized Official - Middle Name:CERVANTES
Authorized Official - Last Name:PAJE
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED CONSULTANT
Authorized Official - Phone:415-715-4646
Mailing Address - Street 1:1730 S AMPHLETT BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-2709
Mailing Address - Country:US
Mailing Address - Phone:650-844-7442
Mailing Address - Fax:650-523-4444
Practice Address - Street 1:1730 S AMPHLETT BLVD STE 107
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-2709
Practice Address - Country:US
Practice Address - Phone:650-844-7442
Practice Address - Fax:650-523-4444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No251G00000XAgenciesHospice Care, Community BasedGroup - Multi-Specialty