Individual provider Active NPI

Annie Song, N.P.

  • Registered Nurse
  • Oakland, CA
National Provider Identifier
1013189869
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
17647 Issued in CA
Practice address
10700 Macarthur Blvd
Oakland, CA 94605
Phone
(510) 563-4300
NPI assigned
Apr 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 17647 CA Primary

Addresses

Primary practice location

10700 Macarthur Blvd
Oakland, CA 94605

Mailing address

10700 Macarthur Blvd
Oakland, CA 94605
Phone (510) 563-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240312001097 CA Practitioner - Nurse Practitioner 0042656134 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Terri R Dunn MD a Medical Corporation CurrentSince Jun 17, 2024 Accepting new patients
City Health, a Medical Corporation CurrentSince Jan 28, 2024 Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients
UCSF Health Community Hospitals Past Accepting new patients

Locations

2828 Telegraph Ave
Berkeley, CA 94705
Phone (510) 644-4488

201 Dolores Ave
San Leandro, CA 94577
Phone (510) 984-2489

13690 E 14th St
Ste 100
San Leandro, CA 94578
Phone (510) 984-2489

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1013189869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 MACARTHUR BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94605",
            "telephone_number": "510-563-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 MACARTHUR BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94605",
            "telephone_number": "510-563-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "ANNIE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "17647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.