Active NPI
Ivan M Prado
- Health Educator
- Livingston, CA
National Provider Identifier
1154895589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- Practice address
- 1140 Main St
Livingston, CA 95334-1257 - Phone
- (209) 446-2771
- NPI assigned
- Jan 18, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | Primary |
Addresses
Primary practice location
1140 Main St
Livingston, CA 95334-1257
Mailing address
2906 Secretariat Dr
Atwater, CA 95301-2534
Phone (209) 761-2125
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547769600000",
"number": "1154895589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2906 SECRETARIAT DR",
"city": "ATWATER",
"state": "CA",
"postal_code": "953012534",
"telephone_number": "209-761-2125",
"fax_number": "209-394-1326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1140 MAIN ST",
"city": "LIVINGSTON",
"state": "CA",
"postal_code": "953341257",
"telephone_number": "209-446-2771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRADO",
"first_name": "IVAN",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-01-18",
"last_updated": "2019-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livingston, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.