Individual provider Active NPI

Jaap Kaur Waraich, M.D.

  • Psychiatry Physician
  • Fremont, CA
National Provider Identifier
1316132285
Registry record updated Oct 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G67904 Issued in CA
Practice address
722 Mowry Ave
Fremont, CA 94536-4115
Phone
(510) 494-9313
Fax
(510) 494-9991
NPI assigned
Sep 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X G67904 CA
Psychiatry Physician 2084P0800X G67904 CA Primary

Addresses

Primary practice location

722 Mowry Ave
Fremont, CA 94536-4115

Mailing address

39120 Argonaut Way
284
Fremont, CA 94538-1304
Phone (510) 494-9313

Other identifiers 1

IdentifierTypeStateIssuer
00G679040MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120426000374 CA Practitioner - Psychiatry 7517129190 Practice locations: Fremont, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G67904CAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317945600000",
    "number": "1316132285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39120 ARGONAUT WAY",
            "address_2": "284",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381304",
            "telephone_number": "510-494-9313",
            "fax_number": "510-494-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 MOWRY AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945364115",
            "telephone_number": "510-494-9313",
            "fax_number": "510-494-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARAICH",
        "first_name": "JAAP",
        "middle_name": "KAUR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-12",
        "last_updated": "2011-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "CA",
            "license": "G67904",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G67904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G679040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.