Active NPI
Cammy Green, LEP
- School Psychologist
- Oakland, CA
National Provider Identifier
1255919262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 4029
- Practice address
- 1000 Broadway Ste 460
Oakland, CA 94607-4033 - Phone
- (415) 730-8334
- NPI assigned
- Mar 31, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 4029 | CA | Primary |
Addresses
Primary practice location
1000 Broadway Ste 460
Oakland, CA 94607-4033
Mailing address
887 Portal Ave
Oakland, CA 94610-1265
Phone (415) 730-8334
Other practice location 1
948 Hollister Ave
San Francisco, CA 94124-3724
Phone (415) 703-8334
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4029 | CA | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617148800000",
"number": "1255919262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "887 PORTAL AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946101265",
"telephone_number": "415-730-8334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 BROADWAY STE 460",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946074033",
"telephone_number": "415-730-8334"
}
],
"practiceLocations": [
{
"address_1": "948 Hollister Ave",
"address_purpose": "LOCATION",
"city": "San Francisco",
"state": "CA",
"postal_code": "941243724",
"country_code": "US",
"telephone_number": "415-703-8334",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GREEN",
"first_name": "CAMMY",
"credential": "LEP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-31",
"last_updated": "2021-03-31",
"certification_date": "2021-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "CA",
"license": "4029",
"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 Mar 31, 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.