Individual provider Active NPI

Alanna Spencer

  • Mental Illness Community Based Residential Treatment Facility
  • Hayward, CA
National Provider Identifier
1083233886
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
019201069 Issued in CA
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

Updated by the provider on May 18, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
019201069CAMDMental Illness Community Based Residential Treatment Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Gentle Heart Care Services Adult Care Home CurrentSince May 25, 2021 Accepting new patients
The Resource Environment for Underprivileged Groups Enterprise, Inc. Community Based Residential Treatment Facility, Mental Illness PastSince Apr 1, 2020 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.

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.

Verify at the official NPI Registry.