Individual provider Active NPI

Yohannes Fesseha Gebrehiwet

  • Student in an Organized Health Care Education/Training Program
  • Oakland, CA
National Provider Identifier
1316553290
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
INT46728 Issued in CA
Practice address
2221 9TH Ave
Oakland, CA 94606-2613
Phone
(317) 457-6690
NPI assigned
Sep 16, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X INT46728 CA Primary

Addresses

Primary practice location

2221 9TH Ave
Oakland, CA 94606-2613

Mailing address

2221 9TH Ave
Oakland, CA 94606-2613
Phone (317) 457-6690

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

LicenseStateTypeSpecialty
INT46728CAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1316553290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 9TH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946062613",
            "telephone_number": "317-457-6690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 9TH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946062613",
            "telephone_number": "317-457-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEBREHIWET",
        "first_name": "YOHANNES",
        "middle_name": "FESSEHA",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "INT46728",
            "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 Sep 16, 2020; 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.