Organization Active NPI

Herman Rus Medical Professional Corporation

  • Clinic/Center
  • Menlo Park, CA
National Provider Identifier
1174115000
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
HERMAN RUS MEDICAL PROFESSIONAL CORPORATION
Doing business as
Soft Reboot Wellness
Practice address
825 Oak Grove Ave Ste A101
Menlo Park, CA 94025-4427
Phone
(650) 419-3330
NPI assigned
Feb 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Authorized official

Name
Dr. Sara C Herman, MDNPI 1407027196
Title
Owner
Phone
(650) 419-3330

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

825 Oak Grove Ave Ste A101
Menlo Park, CA 94025-4427

Mailing address

825 Oak Grove Ave Ste A101
Menlo Park, CA 94025-4427
Phone (650) 419-3330

Other names 1

  • Soft Reboot Wellness Doing business as

National Provider Directory

National Provider Directory

Locations

825 Oak Grove Ave
Ste A101
Menlo Park, CA 94025
Phone (415) 321-1916

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637625600000",
    "number": "1174115000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 OAK GROVE AVE STE A101",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254427",
            "telephone_number": "650-419-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 OAK GROVE AVE STE A101",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254427",
            "telephone_number": "650-419-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERMAN RUS MEDICAL PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-11",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-419-3330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Soft Reboot Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Menlo Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.

Verify at the official NPI Registry.