Active NPI
Alanna Spencer
- Mental Illness Community Based Residential Treatment Facility
- Hayward, CA
National Provider Identifier
1083233886
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Community Based Residential Treatment Facility
- License
- 019201069
- Practice address
- 1559 D St
Hayward, CA 94541-4318 - Phone
- (510) 397-4813
- Fax
- (510) 856-5102
- NPI assigned
- Apr 11, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Adult Care Home Facility | 311ZA0620X | 019201069 | CA | |
| Mental Illness Community Based Residential Treatment Facility | 320800000X | 019201069 | CA | Primary |
Addresses
Primary practice location
1559 D St
Hayward, CA 94541-4318
Mailing address
PO Box 4084
Hayward, CA 94540-4084
Phone (510) 342-6740
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019201069 | CA | MD | Mental Illness Community Based Residential Treatment Facility |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gentle Heart Care Services | Adult Care Home | Current | Accepting new patients |
| The Resource Environment for Underprivileged Groups Enterprise, Inc. | Community Based Residential Treatment Facility, Mental Illness | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Mental Illness Community Based Residential Treatment Facility
- Hayward, CA
- NPI 1497329874
Adult Care Home
-
- Mental Illness Community Based Residential Treatment Facility
- San Leandro, CA
- NPI 1275033797
Community Based Residential Treatment Facility, Mental Illness
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621296000000",
"number": "1083233886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4084",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945404084",
"telephone_number": "510-342-6740",
"fax_number": "510-856-5102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1559 D ST",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945414318",
"telephone_number": "510-397-4813",
"fax_number": "510-856-5102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPENCER",
"first_name": "ALANNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-11",
"last_updated": "2021-05-18",
"certification_date": "2021-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "CA",
"license": "019201069",
"primary": false
},
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": "CA",
"license": "019201069",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hayward, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.