Individual provider Active NPI

Carla Yavette Ervin, CPT01008218

  • Phlebotomy Technician
  • San Leandro, CA
National Provider Identifier
1104332873
Registry record updated Dec 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
License
CPT01008218 Issued in CA
Practice address
1515 Aurora Dr
San Leandro, CA 94577-3105
Phone
(510) 969-7178
NPI assigned
Dec 18, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 246RP1900X CPT01008218 CA Primary

Addresses

Primary practice location

1515 Aurora Dr
San Leandro, CA 94577-3105

Mailing address

30042 Mission Blvd # 121222
Hayward, CA 94544-7255
Phone (510) 585-1312

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
CPT01008218CAMDPhlebotomy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
A Touch of Class Phlebotomy Services Single Specialty Past Accepting new patients

Organizations & group practices 1

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": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513555200000",
    "number": "1104332873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30042 MISSION BLVD # 121222",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945447255",
            "telephone_number": "510-585-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 AURORA DR",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945773105",
            "telephone_number": "510-969-7178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERVIN",
        "first_name": "CARLA",
        "middle_name": "YAVETTE",
        "credential": "CPT01008218",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-18",
        "last_updated": "2017-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "CA",
            "license": "CPT01008218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2017; 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.