Provider Demographics
NPI:1487956751
Name:PENINSULA VOLUNTEERS, INC.
Entity type:Organization
Organization Name:PENINSULA VOLUNTEERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAO
Authorized Official - Middle Name:
Authorized Official - Last Name:DO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-322-0126
Mailing Address - Street 1:800 MIDDLE AVE
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-5121
Mailing Address - Country:US
Mailing Address - Phone:650-326-0665
Mailing Address - Fax:650-326-9547
Practice Address - Street 1:500 ARBOR RD
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-5132
Practice Address - Country:US
Practice Address - Phone:650-322-0126
Practice Address - Fax:650-543-4773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-18
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA415600288251V00000X
261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA63904049OtherDEPT OF VETERANS AFFAIRS