Active NPI
Marie Broadway
- Counselor
- Oakland, CA
National Provider Identifier
1255837308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 3301 E 12TH St
Oakland, CA 94601-3424 - Phone
- (413) 695-8781
- NPI assigned
- Apr 5, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | |||
| Counselor | 101Y00000X | CA | Primary |
Addresses
Primary practice location
3301 E 12TH St
Oakland, CA 94601-3424
Mailing address
628 Beacon St
Oakland, CA 94610-3608
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524096000000",
"number": "1255837308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "628 BEACON ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946103608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3301 E 12TH ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946013424",
"telephone_number": "413-695-8781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROADWAY",
"first_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-05",
"last_updated": "2018-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.