Active NPI
Diana Bada de Ross, PHARMD
- Pharmacist
- Thousand Oaks, CA
National Provider Identifier
1164185146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 66205
- Practice address
- 945 Calle Tulipan
Thousand Oaks, CA 91360-4826 - Phone
- (707) 246-5640
- NPI assigned
- Oct 18, 2021
- Last updated
- Oct 18, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 66205 | CA | Primary |
Addresses
Primary practice location
945 Calle Tulipan
Thousand Oaks, CA 91360-4826
Mailing address
945 Calle Tulipan
Thousand Oaks, CA 91360-4826
Phone (707) 246-5640
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5874 | Other | HEALTH PARTNERS |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | securerecords.sandford.html | ||
| CONNECT URL | securerecords.sandford.html | Centene Management Company LLC |
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 66205 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634515200000",
"number": "1164185146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "945 CALLE TULIPAN",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913604826",
"telephone_number": "707-246-5640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "945 CALLE TULIPAN",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913604826",
"telephone_number": "707-246-5640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BADA DE ROSS",
"first_name": "DIANA",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-18",
"last_updated": "2021-10-18",
"certification_date": "2021-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "66205",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "5874",
"state": null
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "securerecords.sandford.html",
"affiliation": "N",
"address_1": "945 Calle Tulipan",
"city": "Thousand Oaks",
"state": "CA",
"country_code": "US",
"postal_code": "913604826",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "securerecords.sandford.html",
"affiliation": "Y",
"affiliationName": "Centene Management Company LLC",
"address_1": "7700 Forsyth Blvd.",
"city": "St. Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631051837",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Thousand Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 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.