NPI |
1184835167 |
The 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 Code |
1 |
Code 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 Name |
BLEAKLEY |
The last name of the provider. If the provider is an individual, this is the legal name. |
Provider First Name |
JOYCE |
The first name of the provider, if the provider
is an individual. |
Provider Middle Name |
MAUREEN |
The middle name of the provider, if the provider
is an individual. |
Provider Name Prefix Text |
MRS. |
The name prefix or salutation of the provider
if the provider is an individual; for example, Mr., Mrs., or Corporal. |
Provider Credential Text |
BA |
The abbreviations for professional degrees or credentials used or held by the provider,
if the provider is an individual. Examples
are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations
will not be verified by NPS. |
Provider Other Last Name |
CAMBRA |
The 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 Other First Name |
JOYCE |
The city name in the location address of the provider being identified. |
Provider Other Middle Name |
MAUREEN |
The State code in the location of the provider
being identified. |
Provider Other Name Prefix Text |
MRS. |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider Other Credential Text |
BA |
The country code in the location address of the provider being identified. |
Provider Other Last Name Type Code |
1 |
The telephone number associated with the location address of the provider being identified. |
Provider First Line Business Practice Location Address |
333 HEGENBERGER RD |
The date the provider was assigned a unique identifier (assigned an NPI). |
Provider Second Line Business Practice Location Address |
SUITE 600 |
The date that a record was last updated or changed. |
Provider Business Practice Location Address City Name |
OAKLAND |
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider. |
Provider Business Practice Location Address State Name |
CA |
The first name of the authorized official. |
Provider Business Practice Location Address Postal Code |
946211420 |
The middle name of the authorized official. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The title or position of the authorized official. |
Provider Business Practice Location Address Telephone Number |
5103831640 |
The 10-position telephone number of the authorized official. |
Provider Business Practice Location Address Fax Number |
5103831616 |
Code 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. |
Provider Enumeration Date |
5/24/2007 |
|
Last Update Date |
7/8/2007 |
|
Provider Gender Code |
F |
|
Healthcare Provider Taxonomy Code 1 |
101Y00000X |
|
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
Is Sole Proprietor |
Y |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |