Teen Kitchen Project

Primary specialty

Home Delivered MealsTaxonomy code 332U00000X

Legal business name

TEEN KITCHEN PROJECT

Practice address

2880 Research Park Dr Ste 200
Soquel, CA 95073-2042

Phone

(831) 316-4540

Fax

(831) 316-4540

NPI assigned

Nov 3, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Angela Farley

Title

Executive Director

Phone

(831) 316-4540

Specialties & licenses 1

Addresses

Other names 1

• The Boomerang Foundation Other name

Electronic endpoints 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604361600000",
    "number": "1023619418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1853",
            "city": "SOQUEL",
            "state": "CA",
            "postal_code": "950731853",
            "telephone_number": "831-316-4540",
            "fax_number": "831-316-4540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 RESEARCH PARK DR STE 200",
            "city": "SOQUEL",
            "state": "CA",
            "postal_code": "950732042",
            "telephone_number": "831-316-4540",
            "fax_number": "831-316-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEEN KITCHEN PROJECT",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-03",
        "last_updated": "2020-11-03",
        "certification_date": "2020-10-22",
        "status": "A",
        "authorized_official_last_name": "FARLEY",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "831-316-4540"
    },
    "taxonomies": [
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clientservices@teenkitchenproject.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "none",
            "address_1": "2880 Research Park Dr Ste 200",
            "city": "Soquel",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950732042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "The Boomerang Foundation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Carol Sun, MFT
• Susannah Lee Lac, Inc
• Shauna Sutton
• Deborah Ann Syren-Vitullo, PH.D.
• Olivia Jennifer Tecce, PA-C
• Jo Ellen Tennyson-Samson, OTR
• Laura A Terrazas, RD
• Christy Texeira-Smith, LCSW
• The Osteopathic Way, P.C
• Peter Thibodeau, D.C.

• Home Delivered Meals in Soquel, CA
• Providers in Soquel, CA by specialty
• Home Delivered Meals in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.