Active NPI
A.K. Bean Foundation
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Vallejo, CA
National Provider Identifier
1629438775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Legal business name
- A.K. BEAN FOUNDATION
- Practice address
- 2100 Sacramento St
Vallejo, CA 94590-3126 - Phone
- (707) 642-4789
- Fax
- (707) 642-8882
- NPI assigned
- Mar 2, 2016
- Last updated
- Apr 27, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Denee Marie Tysol, SUDRC
- Title
- Program Manager
- Phone
- (707) 664-7798
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Comprehensive Outpatient Rehabilitation Facility (CORF) | 261QR0401X | Primary |
Addresses
Primary practice location
2100 Sacramento St
Vallejo, CA 94590-3126
Mailing address
2100 Sacramento St
Vallejo, CA 94590-3126
Phone (707) 642-8947
National Provider Directory
National Provider Directory- Tax ID family
- Ak Bean Foundation
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Vacaville, CA
- NPI 1073973129
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Fairfield, CA
- NPI 1154781276
Locations
2100 Sacramento St
Vallejo, CA 94590
Phone (707) 642-4789
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Day Training/Habilitation Specialist
- Napa, CA
- NPI 1417894486
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456876800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1682553600000",
"number": "1629438775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 SACRAMENTO ST",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945903126",
"telephone_number": "707-642-8947",
"fax_number": "707-429-1908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 SACRAMENTO ST",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945903126",
"telephone_number": "707-642-4789",
"fax_number": "707-642-8882"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "A.K. BEAN FOUNDATION",
"organizational_subpart": "NO",
"enumeration_date": "2016-03-02",
"last_updated": "2023-04-27",
"certification_date": "2023-04-27",
"status": "A",
"authorized_official_last_name": "TYSOL",
"authorized_official_first_name": "DENEE",
"authorized_official_middle_name": "MARIE",
"authorized_official_title_or_position": "PROGRAM MANAGER",
"authorized_official_telephone_number": "707-664-7798",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "SUDRC"
},
"taxonomies": [
{
"code": "261QR0401X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.