NPIMap

Organization Active NPI

Senior Support Program of the Tri Valley

  • Community/Behavioral Health Agency
  • Pleasanton, CA
National Provider Identifier
1730367178
Registry record updated Feb 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
2758503 Issued in CA
Legal business name
SENIOR SUPPORT PROGRAM OF THE TRI VALLEY
Practice address
5353 Sunol Blvd
Pleasanton, CA 94566-7607
Phone
(925) 931-5379
NPI assigned
Feb 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2008

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

Authorized official

Name
Mrs. Marlene J Petersen
Title
Executive Director
Phone
(925) 931-5378

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 2758503 CA
Community/Behavioral Health Agency 251S00000X 2758503 CA Primary

Addresses

Primary practice location

5353 Sunol Blvd
Pleasanton, CA 94566-7607

Mailing address

5353 Sunol Blvd
Pleasanton, CA 94566-7607
Phone (925) 931-5379

National Provider Directory

National Provider Directory
Tax ID family
Senior Support Program of the Tri Valley2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

5353 Sunol Blvd
Pleasanton, CA 94566
Phone (925) 931-5379

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202342400000",
    "number": "1730367178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5353 SUNOL BLVD",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945667607",
            "telephone_number": "925-931-5379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 SUNOL BLVD",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945667607",
            "telephone_number": "925-931-5379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR SUPPORT PROGRAM OF THE TRI VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-07",
        "last_updated": "2008-02-07",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "MARLENE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "925-931-5378",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "CA",
            "license": "2758503",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "2758503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.