NPIMap

Organization Active NPI

Easter Seal Society of Superior California

  • Physical Medicine & Rehabilitation Physician
  • Stockton, CA
National Provider Identifier
1720359490
Registry record updated Dec 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
EASTER SEAL SOCIETY OF SUPERIOR CALIFORNIA
Practice address
7273 Murray Dr Ste 1
Stockton, CA 95210-3385
Phone
(209) 957-3625
Fax
(209) 957-6031
NPI assigned
Jan 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2018

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

Authorized official

Name
Hoan Nguyen
Title
Cfo
Phone
(916) 485-6711

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Early Intervention Provider Agency 252Y00000X

Addresses

Primary practice location

7273 Murray Dr Ste 1
Stockton, CA 95210-3385

Mailing address

3205 Hurley Way
Sacramento, CA 95864-3853
Phone (916) 485-6711

Other practice location 1

3205 Hurley Way
Sacramento, CA 95864-6543
Phone (916) 485-6711

Other names 1

  • Easter Seals Superior California Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Easter Seal Society of Superior California6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7273 Murray Dr
Ste 1
Stockton, CA 95210
Phone (209) 957-3625

NPI Registry JSON

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

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544140800000",
    "number": "1720359490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 HURLEY WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958643853",
            "telephone_number": "916-485-6711",
            "fax_number": "916-485-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7273 MURRAY DR STE 1",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952103385",
            "telephone_number": "209-957-3625",
            "fax_number": "209-957-6031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3205 Hurley Way",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958646543",
            "country_code": "US",
            "telephone_number": "916-485-6711",
            "fax_number": "916-485-2653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EASTER SEAL SOCIETY OF SUPERIOR CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-26",
        "last_updated": "2018-12-07",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "HOAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "916-485-6711"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Easter Seals Superior California",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2018; 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.