NPIMap

Organization Active NPI

California State University East Bay

  • Student Health Clinic/Center
  • Hayward, CA
National Provider Identifier
1366422776
Registry record updated Jul 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
CALIFORNIA STATE UNIVERSITY EAST BAY
Practice address
25800 Carlos Bee Blvd
Hayward, CA 94542
Phone
(510) 885-3735
Fax
(510) 885-3230
NPI assigned
Jan 20, 2006
Organization subpart
Yes
Parent organization
CALIFORNIA STATE UNIVERSITY EAST BAYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 29, 2008

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

Authorized official

Name
Cathleen U Coulman, MD
Title
Executive Director Student Health S
Phone
(510) 885-3639

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

25800 Carlos Bee Blvd
Hayward, CA 94542

Mailing address

25800 Carlos Bee Blvd
Hayward, CA 94542
Phone (510) 885-3735

Other identifiers 1

IdentifierTypeStateIssuer
GR0089820MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
California State University East Bay3 organizations share this tax ID, including this one
Part of
California State University East Bay

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

25800 Carlos Bee Blvd
Hayward, CA 94542
Phone (510) 885-3650

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217289600000",
    "number": "1366422776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25800 CARLOS BEE BLVD",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "94542",
            "telephone_number": "510-885-3735",
            "fax_number": "510-885-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25800 CARLOS BEE BLVD",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "94542",
            "telephone_number": "510-885-3735",
            "fax_number": "510-885-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA STATE UNIVERSITY EAST BAY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CALIFORNIA STATE UNIVERSITY EAST BAY",
        "enumeration_date": "2006-01-20",
        "last_updated": "2008-07-29",
        "status": "A",
        "authorized_official_last_name": "COULMAN",
        "authorized_official_first_name": "CATHLEEN",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR STUDENT HEALTH S",
        "authorized_official_telephone_number": "510-885-3639",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0089820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; 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.