Individual provider Active NPI

Jocelyn Rafanan

  • Home Health Registered Nurse
  • Fremont, CA
National Provider Identifier
1164262424
Registry record updated May 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
95043650 Issued in CA
Practice address
3340 Walnut Ave
Fremont, CA 94538-2215
Phone
(510) 651-8500
NPI assigned
May 25, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 95043650 CA Primary

Addresses

Primary practice location

3340 Walnut Ave
Fremont, CA 94538-2215

Mailing address

36915 Locust St
Newark, CA 94560-2818

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
95043650CAMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1716595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716595200000",
    "number": "1164262424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36915 LOCUST ST",
            "city": "NEWARK",
            "state": "CA",
            "postal_code": "945602818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 WALNUT AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382215",
            "telephone_number": "510-651-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFANAN",
        "first_name": "JOCELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-25",
        "last_updated": "2024-05-25",
        "certification_date": "2024-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "CA",
            "license": "95043650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2024; 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.