Individual provider Active NPI

Marwa Kassem

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Livermore, CA
National Provider Identifier
1326600750
Registry record updated Jul 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
69112 Issued in CA
Practice address
4405 1St St
Livermore, CA 94551-4915
Phone
(925) 373-8124
NPI assigned
Jul 5, 2019
Last updated
Jul 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 69112 CA Primary

Addresses

Primary practice location

4405 1St St
Livermore, CA 94551-4915

Mailing address

4405 1St St
Livermore, CA 94551-4915

Other practice location 1

3079 Tahoe Pl
San Ramon, CA 94582-4853
Phone (925) 487-6086

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

Practice roles

OrganizationSpecialtyStatusNew patients
Longs Drug Stores California LLC Past Accepting new patients
Longs Drug Store California LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1562284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562284800000",
    "number": "1326600750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 1ST ST",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945514915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 1ST ST",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945514915",
            "telephone_number": "925-373-8124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3079 Tahoe Pl",
            "address_purpose": "LOCATION",
            "city": "San Ramon",
            "state": "CA",
            "postal_code": "945824853",
            "country_code": "US",
            "telephone_number": "925-487-6086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASSEM",
        "first_name": "MARWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-05",
        "last_updated": "2019-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CA",
            "license": "69112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livermore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2019; 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.