Organization Active NPI

Healthdrive Medical Services of California, LLC

  • Nurse Practitioner
  • San Jose, CA
National Provider Identifier
1073218913
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
HEALTHDRIVE MEDICAL SERVICES OF CALIFORNIA, LLC
Practice address
99 Almaden Blvd Ste 600
San Jose, CA 95113-1605
Phone
(888) 964-6681
Fax
(888) 662-0859
NPI assigned
Mar 31, 2023
Last updated
Mar 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Authorized official

Name
Daniel Baker
Title
President
Phone
(888) 964-6681

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary
Family Nurse Practitioner 363LF0000X NU

Addresses

Primary practice location

99 Almaden Blvd Ste 600
San Jose, CA 95113-1605

Mailing address

100 Crossing Blvd Ste 300
Framingham, MA 01702-5555
Phone (617) 964-6681

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680220800000",
    "number": "1073218913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CROSSING BLVD STE 300",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017025555",
            "telephone_number": "617-964-6681",
            "fax_number": "339-686-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 ALMADEN BLVD STE 600",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951131605",
            "telephone_number": "888-964-6681",
            "fax_number": "888-662-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHDRIVE MEDICAL SERVICES OF CALIFORNIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-31",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-964-6681"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Mar 31, 2023; 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.