Individual provider Active NPI

Nazila Barahmani, NP

  • Nurse Practitioner
  • Tracy, CA
National Provider Identifier
1174165583
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95012995 Issued in CA
Practice address
2160 W Grant Line Rd Ste 210
Tracy, CA 95377-7333
Phone
(209) 229-7245
Fax
(209) 229-7247
NPI assigned
Oct 17, 2019
Last updated
Oct 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95012995 CA Primary

Addresses

Primary practice location

2160 W Grant Line Rd Ste 210
Tracy, CA 95377-7333

Mailing address

2804 Mission College Blvd Ste 210
Santa Clara, CA 95054-1842
Phone (650) 325-6000

Other practice location 1

2160 W Grant Line Rd Ste 210
Tracy, CA 95377-7333
Phone (209) 229-7245

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95012995CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Berman Skin Institute Medical Group Inc Single Specialty CurrentSince Oct 20, 2019 Accepting new patients

Locations

2160 W Grant Line Rd
Ste 210
Tracy, CA 95377
Phone (209) 229-7245

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1174165583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 MISSION COLLEGE BLVD STE 210",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950541842",
            "telephone_number": "650-325-6000",
            "fax_number": "650-325-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 W GRANT LINE RD STE 210",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953777333",
            "telephone_number": "209-229-7245",
            "fax_number": "209-229-7247"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2160 W Grant Line Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Tracy",
            "state": "CA",
            "postal_code": "953777333",
            "country_code": "US",
            "telephone_number": "209-229-7245",
            "fax_number": "209-229-7247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARAHMANI",
        "first_name": "NAZILA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-17",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95012995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.

Verify at the official NPI Registry.