Jeremy Justin Todd

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

716058 Issued in CA

Practice address

2050 Fairmont Dr
San Leandro, CA 94578-1001

Phone

(510) 924-0548

NPI assigned

Jul 9, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1205407228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ESTUDILLO AVE STE 100",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774962",
            "telephone_number": "510-924-0548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 FAIRMONT DR",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945781001",
            "telephone_number": "510-924-0548"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Estudillo Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "San Leandro",
            "state": "CA",
            "postal_code": "945774962",
            "country_code": "US",
            "telephone_number": "510-924-0548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TODD",
        "first_name": "JEREMY",
        "middle_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-09",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "716058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vijay Prakash Tiwari, M.D.
• Louise T To-Tanaka, P.T.
• Kellsa Rose Toatelegese
• Gabriel Tobias
• Sheridan Michelle Tobin
• Ashley Toledo
• Miye Tom
• David Richard Tomasini, M.D.
• Lisa Anne Tompkins, LMFT
• Alexandra Mai Tamayo Tong, PA-C

• Licensed Vocational Nurse in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; 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.