Individual provider Active NPI

Angelica Kholine Encarnado

  • Rehabilitation Practitioner
  • San Leandro, CA
National Provider Identifier
1164353181
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
2050 Fairmont Dr
Building B
San Leandro, CA 94578
Phone
(510) 483-3030
NPI assigned
May 27, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X Primary

Addresses

Primary practice location

2050 Fairmont Dr
Building B
San Leandro, CA 94578

Mailing address

2050 Fairmont Dr
Building B
San Leandro, CA 94578
Phone (510) 483-3030

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": "1779840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1164353181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 FAIRMONT DR",
            "address_2": "BUILDING B",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "94578",
            "telephone_number": "510-483-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 FAIRMONT DR",
            "address_2": "BUILDING B",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "94578",
            "telephone_number": "510-483-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENCARNADO",
        "first_name": "ANGELICA KHOLINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-27",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; 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.