Individual provider Active NPI

Fam Fow Saefong

  • Rehabilitation Practitioner
  • San Francisco, CA
National Provider Identifier
1336624352
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
990 Eddy St
San Francisco, CA 94109-7713
Phone
(510) 965-5995
NPI assigned
Sep 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X
Rehabilitation Practitioner 225400000X Primary

Addresses

Primary practice location

990 Eddy St
San Francisco, CA 94109-7713

Mailing address

2865 Oxford Ave
Richmond, CA 94806-2616
Phone (510) 965-5995

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

NPI Registry JSON

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1336624352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 OXFORD AVE",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948062616",
            "telephone_number": "510-965-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 EDDY ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941097713",
            "telephone_number": "510-965-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAEFONG",
        "first_name": "FAM FOW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-25",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.