Basic Information
| Provider Information | |||||||||
| NPI: | 1669852380 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DOOR TO HOPE | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 130 W GABILAN ST | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939012762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317580181 | ||||||||
| FaxNumber: | 8317585127 | ||||||||
| Practice Location | |||||||||
| Address1: | 130 W GABILAN ST | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939012762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317580181 | ||||||||
| FaxNumber: | 8317585127 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2015 | ||||||||
| LastUpdateDate: | 06/08/2015 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | NEILSON | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PAT EDUCATOR | ||||||||
| AuthorizedOfficialTelephone: | 8317580181 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MA | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 252Y00000X | Y | Agencies | Early Intervention Provider Agency |
No ID Information.