Individual provider Active NPI

Dawn Marie Polich, R.R.T

  • Registered Respiratory Therapist
  • San Jose, CA
National Provider Identifier
1356708663
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Respiratory TherapistTaxonomy code 227900000X
License
37197 Issued in CA
Practice address
1919 Fruitdale Ave Apt D15
San Jose, CA 95128-4901
Phone
(408) 429-5683
NPI assigned
Jan 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Respiratory Therapist 227900000X 37197 CA Primary

Addresses

Primary practice location

1919 Fruitdale Ave Apt D15
San Jose, CA 95128-4901

Mailing address

1919 Fruitdale Ave. D15
San Jose, CA 95128-4901
Phone (408) 429-5683

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
37197CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1356708663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 FRUITDALE AVE. D15",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951284901",
            "telephone_number": "408-429-5683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 FRUITDALE AVE APT D15",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951284901",
            "telephone_number": "408-429-5683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLICH",
        "first_name": "DAWN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "R.R.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-19",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "227900000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered",
            "state": "CA",
            "license": "37197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; 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.