Berenice Alejandrina Nieto, IBCLC

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

1000 San Leandro Blvd
San Leandro, CA 94577-1598

Phone

(510) 618-3735

Fax

(510) 667-3139

NPI assigned

Sep 23, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Alameda County

  • Case Management Agency
  • San Leandro, CA
  • NPI 1114381837
  NPD (past)

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1063662377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 PACIFIC AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945772517",
            "telephone_number": "510-506-1135",
            "fax_number": "510-667-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SAN LEANDRO BLVD",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945771598",
            "telephone_number": "510-618-3735",
            "fax_number": "510-667-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIETO",
        "first_name": "BERENICE",
        "middle_name": "ALEJANDRINA",
        "credential": "IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-23",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "105-22276",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Mark Nickell, MHRS
• Elizabeth L. Nickels, M.A., PSY.D.
• Kalene Nickelson, ASW
• Joshua Niclas, M.D.
• Brittany Nielsen
• Pamela Nieto
• Margarita Nieves
• Heli T Nikulainen, PHD
• Alena Nikulina
• Ramanpreet Nirwal

• Community Health Worker in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; 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.