Active NPI
John Henry Cotrufo, D.O.
- Psychiatry Physician
- Fremont, CA
National Provider Identifier
1295945467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 20A3470
- Practice address
- 39155 Liberty St Ste G710
Fremont, CA 94538-1525 - Phone
- (510) 795-2434
- Fax
- (510) 793-3972
- NPI assigned
- May 23, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 20A3470 | CA | Primary |
Addresses
Primary practice location
39155 Liberty St Ste G710
Fremont, CA 94538-1525
Mailing address
39155 Liberty St Ste G710
Fremont, CA 94538-1525
Phone (510) 795-2434
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295945467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39155 LIBERTY ST STE G710",
"city": "FREMONT",
"state": "CA",
"postal_code": "945381525",
"telephone_number": "510-795-2434",
"fax_number": "510-793-3972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39155 LIBERTY ST STE G710",
"city": "FREMONT",
"state": "CA",
"postal_code": "945381525",
"telephone_number": "510-795-2434",
"fax_number": "510-793-3972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COTRUFO",
"first_name": "JOHN",
"middle_name": "HENRY",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "20A3470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.