Active NPI
Jennifer An
- Pediatrics Physician
- Richmond, CA
National Provider Identifier
1184019861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 162236
- Practice address
- 150 Harbour Way N
Richmond, CA 94804-2426 - Phone
- (510) 237-9537
- NPI assigned
- Mar 31, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 125067113 | IL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 162236 | CA | Primary |
Addresses
Primary practice location
150 Harbour Way N
Richmond, CA 94804-2426
Mailing address
150 Harbour Way N
Richmond, CA 94804-2426
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 162236 | CA | MD | Pediatrics Physician |
| 125067113 | IL | MD | Pediatrics Physician |
Interoperability endpoints
- jan468896@hisp.ehr.sutterhealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578614400000",
"number": "1184019861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 HARBOUR WAY N",
"city": "RICHMOND",
"state": "CA",
"postal_code": "948042426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 HARBOUR WAY N",
"city": "RICHMOND",
"state": "CA",
"postal_code": "948042426",
"telephone_number": "510-237-9537"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AN",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-31",
"last_updated": "2020-01-10",
"certification_date": "2020-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "125067113",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "162236",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, CA
- Amarjit S Dosanjh MD a Medical Corporation
- American Current Care of California, a Medical Corporation
- Tabitha Ames, CCCE, CLD, CPD, CLE
- Jeanette Amezquita, RN, MSN, FNP-C
- Amy Ray Doula LLC
- Lawrence Ke-Han An, DDS
- Sonal Anand
- Mallory Andersen, CASE MANAGER
- Ashley Nicole Anderson, MA, BS
- Cecil Andrew Anderson Jr.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.