Basic Information
Provider Information
NPI: 1356784532
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EBEL
FirstName: VALERIE
MiddleName: JANE
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 670 9TH ST
Address2: SUITE 203
City: ARCATA
State: CA
PostalCode: 955216248
CountryCode: US
TelephoneNumber: 7078268633
FaxNumber: 7078268628
Practice Location
Address1: 1644 CENTRAL AVE
Address2:  
City: MCKINLEYVILLE
State: CA
PostalCode: 955194342
CountryCode: US
TelephoneNumber: 7078393068
FaxNumber: 7078393827
Other Information
ProviderEnumerationDate: 04/08/2013
LastUpdateDate: 12/21/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VX0000XA132130CAN Allopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
207Q00000XA132130CAY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


Home