Jacob Abjelina
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Oakland, CA
NPI 1184474850 · NPPES record last updated Mar 25, 2024
Key facts
- NPI
- 1184474850
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 3600 Broadway
Oakland, CA 94611-5730 - Phone
- (510) 752-1000
- NPI assigned
- Mar 25, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
3600 Broadway
Oakland, CA 94611-5730
Mailing address
3600 Broadway
Oakland, CA 94611-5730
Phone (510) 752-1000
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All providers in Oakland, CA · Student in an Organized Health Care Education/Training Program in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.