Active NPI
Carol Habercoss
- Dietary Manager
- Oakland, CA
National Provider Identifier
1043628910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dietary Manager
- Practice address
- 6955 Foothill Blvd Ste 188
Oakland, CA 94605-2455 - Phone
- (510) 388-1768
- NPI assigned
- Jul 23, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dietary Manager | 132700000X | CA | Primary |
Addresses
Primary practice location
6955 Foothill Blvd Ste 188
Oakland, CA 94605-2455
Mailing address
14360 Hemlock St
San Leandro, CA 94579-1134
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406073600000",
"number": "1043628910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14360 HEMLOCK ST",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945791134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6955 FOOTHILL BLVD STE 188",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946052455",
"telephone_number": "510-388-1768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HABERCOSS",
"first_name": "CAROL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-23",
"last_updated": "2014-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "132700000X",
"taxonomy_group": "",
"desc": "Dietary Manager",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.