Provider Demographics
NPI:1649434812
Name:ACHIEVEKIDS
Entity type:Organization
Organization Name:ACHIEVEKIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRAINEE
Authorized Official - Prefix:MISS
Authorized Official - First Name:LIEZL
Authorized Official - Middle Name:
Authorized Official - Last Name:TORREFIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-494-1200
Mailing Address - Street 1:3860 MIDDLEFIELD ROAD
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303
Mailing Address - Country:US
Mailing Address - Phone:650-494-1200
Mailing Address - Fax:
Practice Address - Street 1:3860 MIDDLEFIELD RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-4716
Practice Address - Country:US
Practice Address - Phone:650-494-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H0000X302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA01AVOtherMEDICAL PROVIDER NUMBER