MARVA ALBERTHA HARRIS Full NPI Record 1003010547

Counselor - Addiction (Substance Use Disorder) in San Diego, CA

Complete NPI Dataset

The following table represents the complete NPI 1003010547 dataset for Marva Harris in 4335 SWIFT AVE SAN DIEGO, CA 92104. The data table includes a list of all field names, values and definitions of the complete NPI record. The NPI dataset is available for download in CSV format using the "Download NPI" button below at the end of the table.

Name Value Definition
NPI1003010547The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code1Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Last Name Legal NameHARRISThe last name of the provider. If the provider is an individual, this is the legal name.
Provider First NameMARVAThe first name of the provider, if the provider is an individual.
Provider Middle NameALBERTHAThe middle name of the provider, if the provider is an individual.
Provider Other Last NameLEWISOther last name by which the provider being identified is or has been known.
Provider Other First NameMARVAOther first name by which the provider being identified is or has been known (if an individual). This may be the same as the ‘‘Provider first name’’ if the provider is or has been known by a different last name only.
Provider Other Middle NameALBERTHAOther middle name by which the provider being identified is or has been known (if an individual). This may be the same as the ‘‘Provider middle name’’ if the provider is or has been known by a different last name only.
Provider Other Last Name Type Code2Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address4974 EL CAJON BLVDThe first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Second Line Business Mailing AddressSUITE AThe second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Provider Business Mailing Address City NameSAN DIEGOThe city name in the mailing address of the provider being identified.
Provider Business Mailing Address State NameCAThe State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code921154677The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S USThe country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number6192864600The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number6192860060The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address4335 SWIFT AVEThe first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameSAN DIEGOThe city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameCAThe State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code921046613The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S USThe country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number6193585665The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number6193585665The fax number associated with the location address of the provider being identified.
Provider Enumeration Date6/11/2007The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date2/29/2012The date that a record was last updated or changed.
Provider Gender CodeFThe code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1101YA0400XCode designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1Y
Other Provider Identifier 1HDC70114FAdditional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 105Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1CA
Is Sole ProprietorNCode indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No