| Organization Name: | HUMBOLDT STATE UNIVERSITY |
| NPI Number: | 1104991744 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY G. VANCOTT (ASSOCIATE DIRECTOR) |
| Mailing Address: | 1 Harpst St Building 42 Arcata |
| State: | CA US |
| Postal Code: | 955218222 |
| Phone Number: | 7078265019 |
| Fax Number: | 7078265042 |
| NPI Enumeration Date: | 11/21/2006 |
| NPI Last Update Date: | 08/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QS1000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Student Health |
| Taxonomy Definition: | |