NPIMap

Organization Active NPI

Peninsula Family YMCA

  • Health Educator
  • San Mateo, CA
National Provider Identifier
1144662289
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
Legal business name
PENINSULA FAMILY YMCA
Practice address
1877 S Grant St
San Mateo, CA 94402-2647
Phone
(650) 294-2614
NPI assigned
Jul 17, 2013
Organization subpart
Yes
Parent organization
YMCA OF SAN FRANCISCOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Authorized official

Name
Lauren Green, M.S.
Title
Director of Health and Wellness
Phone
(650) 294-2614

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133N00000X
Health EducatorGroup: 193200000X MULTI-SPECIALTY GROUP 174H00000X Primary

Addresses

Primary practice location

1877 S Grant St
San Mateo, CA 94402-2647

Mailing address

1877 S Grant St
San Mateo, CA 94402-2647
Phone (650) 294-2614

National Provider Directory

National Provider Directory
Tax ID family
YMCA of San Francisco8 organizations share this tax ID, including this one
Part of
YMCA of San Francisco

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1877 S Grant St
San Mateo, CA 94402
Phone (650) 294-2614

NPI Registry JSON

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374019200000",
    "number": "1144662289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1877 S GRANT ST",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022647",
            "telephone_number": "650-294-2614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1877 S GRANT ST",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022647",
            "telephone_number": "650-294-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA FAMILY YMCA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "YMCA OF SAN FRANCISCO",
        "enumeration_date": "2013-07-17",
        "last_updated": "2013-07-17",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "DIRECTOR OF HEALTH AND WELLNESS",
        "authorized_official_telephone_number": "650-294-2614",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; 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.