Annette Samuel, PHN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

350793 Issued in CA

Practice address

1000 San Leandro Blvd
San Leandro, CA 94577-1598

Phone

(510) 618-3389

NPI assigned

Oct 31, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Annette Samuel Other name

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": "1193788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193788800000",
    "number": "1134308604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21506",
            "city": "EL SOBRANTE",
            "state": "CA",
            "postal_code": "948201506",
            "telephone_number": "510-758-1691"
        },
        {
            "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": "510-618-3389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "ANNETTE",
        "name_prefix": "Ms.",
        "credential": "PHN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "350793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNETTE",
            "last_name": "SAMUEL",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Marta Jessica Salinas Mendieta
• Rogelio Salinas Jr.
• Ihsana S Salmon
• Jerome Victor Samelson, O.D.
• Sherwin Babadilla Samson
• San Leandro Health Care Center, Inc.
• San Leandro Optometry GRP
• San Leandro Sleep Disorders Center, Prof. Corp.
• San Leandro Surgery Center
• San Leandro Surgery Center LTD

• Registered Nurse in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.