Organization Active NPI

Humu Health LLC

  • Clinic/Center
  • Fairfield, CA
National Provider Identifier
1184387052
Registry record updated Nov 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
HUMU HEALTH LLC
Practice address
1261 Travis Blvd Ste 375
Fairfield, CA 94533-4811
Phone
(707) 763-2515
NPI assigned
Oct 18, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2021

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

Authorized official

Name
Dr. Olukemi A Kuku, DNPNPI 1114417854
Title
Coo
Phone
(707) 763-2515

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

1261 Travis Blvd Ste 375
Fairfield, CA 94533-4811

Mailing address

2401 Waterman Blvd Ste A4-275
Fairfield, CA 94534-1800
Phone (714) 323-3822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211022002392 CA Part B Supplier - Clinic/Group Practice 8426446485 Receives reassigned benefits from 1 practitioner
Practice locations: Fairfield, CA

National Provider Directory

National Provider Directory
Tax ID family
Humu Health Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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": "1634515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637971200000",
    "number": "1184387052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 WATERMAN BLVD STE A4-275",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945341800",
            "telephone_number": "714-323-3822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 TRAVIS BLVD STE 375",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945334811",
            "telephone_number": "707-763-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMU HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-11-27",
        "certification_date": "2021-11-27",
        "status": "A",
        "authorized_official_last_name": "KUKU",
        "authorized_official_first_name": "OLUKEMI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "707-763-2515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.