NPIMap

Organization Active NPI

San Jose Mothers' Milk Bank

  • Specialist
  • San Jose, CA
National Provider Identifier
1033270582
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
CNC80146 Issued in CA
Legal business name
SAN JOSE MOTHERS' MILK BANK
Practice address
1887 Monterey Hwy Ste 110
San Jose, CA 95112-6117
Phone
(408) 998-4550
Fax
(408) 297-9208
NPI assigned
Dec 12, 2006
Last updated
Jun 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Ms. Pauline Tokiko Sakamoto, MS, RN, PHN
Title
Executive Director
Phone
(408) 885-3959

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X CNC80146 CA Primary

Addresses

Primary practice location

1887 Monterey Hwy Ste 110
San Jose, CA 95112-6117

Mailing address

1887 Monterey Hwy Ste 110
San Jose, CA 95112-6117
Phone (408) 998-4550

Other identifiers 2

IdentifierTypeStateIssuer
MMB000020MedicaidCA
164184OtherCACCS CGP NUMBER

National Provider Directory

National Provider Directory
Tax ID family
San Jose Mothers' Milk Bank2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1887 Monterey Hwy
Ste 110
San Jose, CA 95112
Phone (408) 998-4550

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1033270582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1887 MONTEREY HWY STE 110",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951126117",
            "telephone_number": "408-998-4550",
            "fax_number": "408-297-9208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1887 MONTEREY HWY STE 110",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951126117",
            "telephone_number": "408-998-4550",
            "fax_number": "408-297-9208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JOSE MOTHERS' MILK BANK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "SAKAMOTO",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_middle_name": "TOKIKO",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "408-885-3959",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS, RN, PHN"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "CNC80146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MMB000020",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCS CGP NUMBER",
            "identifier": "164184",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.