Active NPI
Jamie Waterman, ATC, EMT
- Basic Emergency Medical Technician
- Kentfield, CA
National Provider Identifier
1326584905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Basic Emergency Medical Technician
- License
- E064579
- Practice address
- 675 Sir Francis Drake Blvd
Kentfield, CA 94901 - Phone
- (415) 464-3800
- NPI assigned
- Jan 6, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Basic Emergency Medical Technician | 146N00000X | E064579 | CA | Primary |
Addresses
Primary practice location
675 Sir Francis Drake Blvd
Kentfield, CA 94901
Mailing address
1788 Alan Dr
Penngrove, CA 94951
Phone (707) 795-2646
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
- Credentials
- Emergency Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E064579 | CA | MD | Basic Emergency Medical Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1483660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483660800000",
"number": "1326584905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1788 ALAN DR",
"city": "PENNGROVE",
"state": "CA",
"postal_code": "94951",
"telephone_number": "707-795-2646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "675 SIR FRANCIS DRAKE BLVD",
"city": "KENTFIELD",
"state": "CA",
"postal_code": "94901",
"telephone_number": "415-464-3800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERMAN",
"first_name": "JAMIE",
"credential": "ATC, EMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-06",
"last_updated": "2017-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "146N00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Basic",
"state": "CA",
"license": "E064579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kentfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.