Individual provider Active NPI

Jemal M Hassen

  • Driver
  • Emeryville, CA
National Provider Identifier
1033939459
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
F3516836 Issued in CA
Practice address
4510 Hubbard St Unit 209
Emeryville, CA 94608-3592
Phone
(415) 910-6566
NPI assigned
Oct 11, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X F3516836 CA Primary

Addresses

Primary practice location

4510 Hubbard St Unit 209
Emeryville, CA 94608-3592

Mailing address

4510 Hubbard St Unit 209
Emeryville, CA 94608-3592
Phone (415) 910-6566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
F3516836CAMDDriver

NPI Registry JSON

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

{
    "created_epoch": "1728604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1033939459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 HUBBARD ST UNIT 209",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946083592",
            "telephone_number": "415-910-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 HUBBARD ST UNIT 209",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946083592",
            "telephone_number": "415-910-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSEN",
        "first_name": "JEMAL",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-11",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "CA",
            "license": "F3516836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emeryville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.