Provider Demographics
NPI:1487434981
Name:PALO ALTO UNIVERSITY
Entity type:Organization
Organization Name:PALO ALTO UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVOST & VP OF ACAD & STUDENT AFFR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:RAISSA NASH
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:650-433-3830
Mailing Address - Street 1:1791 ARASTRADERO RD
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1337
Mailing Address - Country:US
Mailing Address - Phone:800-818-6136
Mailing Address - Fax:
Practice Address - Street 1:1791 ARASTRADERO RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1337
Practice Address - Country:US
Practice Address - Phone:800-818-6136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health