Basic Information
Provider Information
NPI: 1235613191
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANKE
FirstName: CLAUDIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
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OtherLastName:  
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Mailing Information
Address1: 1400 E CHURCH ST
Address2: MEDICAL STAFF OFFICE
City: SANTA MARIA
State: CA
PostalCode: 93454
CountryCode: US
TelephoneNumber: 8057393114
FaxNumber: 8057393502
Practice Location
Address1: 1304 ELLA ST STE A
Address2:  
City: SAN LUIS OBISPO
State: CA
PostalCode: 934014165
CountryCode: US
TelephoneNumber: 8055499555
FaxNumber: 8055490444
Other Information
ProviderEnumerationDate: 09/17/2018
LastUpdateDate: 10/08/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/07/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AM0700XPA56816 Y Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

No ID Information.


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