PRIMARY CARE AT HOME, INC. (NPI# 1962852939) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962852939 |
| Entity Type | Organization |
| Organization Name | PRIMARY CARE AT HOME, INC. |
| Practice Address |
400 29th St Suite 306 Oakland CA 94609-3522 |
| Practice Telephone | 5106100748 |
| Mailing Telephone | 5106100748 |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2016-06-21 |
| Authorized Official Name | ANTHONY E JONES (CHAIR) |
| Authorized Official Telephone | 5106100748 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
CA | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336757103 | Primary Care At Home, Inc. | Internal Medicine | 7750 Michigan Rd, Indianapolis, IN 46268-2324 | 2020-07-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PRIMARY CARE AT HOME, INC. | 400 29th St Ste 360, Oakland, CA 94609-3522 |
| Street Address |
400 29TH ST SUITE 306 |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-3522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245237361 | Ann L. Chappell | Psychiatry & Neurology | 400 29th St, Ste 512, Oakland, CA 94609-3550 | 2005-07-05 |
| 1447862990 | Diego Lopez Suarez | Behavior Technician | 400 29th St, Oakland, CA 94609-3522 | 2020-08-17 |
| 1134730617 | Marisela Antonia Flores | Behavior Technician | 400 29th St, Oakland, CA 94609-3522 | 2020-08-10 |
| 1093325219 | Ashley Samantha Tejada | Behavior Technician | 400 29th St, Oakland, CA 94609-3522 | 2020-08-03 |
| 1669024717 | Brittani Lace Collins | Behavior Technician | 400 29th St, Oakland, CA 94609-3522 | 2019-07-09 |
| 1497211320 | Marsha Gayle Christopher | Behavior Technician | 400 29th St, Oakland, CA 94609-3522 | 2019-02-15 |
| 1811467665 | Leijia William- Lawson | Behavior Technician | 400 29th St, Oakland, CA 94609-3522 | 2018-12-04 |
| 1124501051 | Elana Maria Mccormick | Behavior Technician | 400 29th St, Oakland, CA 94609-3522 | 2018-09-06 |
| 1386122653 | Jessica Teresa Marcus-gomez | Behavior Technician | 400 29th St, Oakland, CA 94609-3522 | 2018-07-30 |
| 1407342827 | Dionnica Rochelle Tolliver | Behavior Technician | 400 29th St, Oakland, CA 94609-3522 | 2018-07-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
| 1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
| 1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
| 1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
| 1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
| 1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
| 1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
| 1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
| Find all providers in zip 94609 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.