Individual provider Active NPI

Jessika Jace Lawa

  • Student in an Organized Health Care Education/Training Program
  • Berkeley, CA
National Provider Identifier
1184281081
Registry record updated May 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2712 Telegraph Ave
Berkeley, CA 94705-1117
Phone
(510) 548-8283
NPI assigned
May 26, 2019
Last updated
May 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

2712 Telegraph Ave
Berkeley, CA 94705-1117

Mailing address

275 Macarthur Blvd Apt B
Oakland, CA 94610-3135
Phone (760) 553-4704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Sep 2, 2024 through Sep 2, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Center for Human Growth PastSince Oct 1, 2023 Accepting new patients
Pacific Center for Human Growth Past Accepting new patients

Organizations & group practices 2

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": "1558828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558828800000",
    "number": "1184281081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 MACARTHUR BLVD APT B",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946103135",
            "telephone_number": "760-553-4704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2712 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051117",
            "telephone_number": "510-548-8283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWA",
        "first_name": "JESSIKA",
        "middle_name": "JACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-26",
        "last_updated": "2019-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.