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Kaiser Permanente

Organization Active NPI Genetic Counselor (M.S.) · Oakland, CA

NPI 1366825754 · NPPES record last updated Jul 2, 2015

Key facts

NPI
1366825754
Entity type
Organization (NPI type 2)
Primary specialty
Genetic Counselor (M.S.) 170300000X
License
GC000653 (CA)
Legal business name
KAISER PERMANENTE
Practice address
3505 Broadway
Mosswood Building, 10TH Floor
Oakland, CA 94611-5714
Phone
(510) 752-6396
NPI assigned
Jul 2, 2015
Organization subpart
No

Authorized official

Name
Robbie F Fox, MS, CGC
Title
Genetics Clinical Services Manager
Phone
(510) 752-6396

Corporate family (same tax ID) 24

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

National Provider Directory

Tax ID family
Perm Med GRP Inc (26 organizations share this tax ID)

Locations

3505 Broadway
Bldg 10TH
Oakland, CA 94611
Phone (510) 752-6396

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Genetic Counselor (M.S.)
Group: 193200000X MULTI-SPECIALTY GROUP		 170300000X GC000653 CA Yes

Addresses

Primary practice location

3505 Broadway
Mosswood Building, 10TH Floor
Oakland, CA 94611-5714

Mailing address

3505 Broadway
Mosswood Building, 10TH Floor
Oakland, CA 94611-5714

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 2, 2015.

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435795200000",
    "number": "1366825754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 BROADWAY",
            "address_2": "MOSSWOOD BUILDING, 10TH FLOOR",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 BROADWAY",
            "address_2": "MOSSWOOD BUILDING, 10TH FLOOR",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115714",
            "telephone_number": "510-752-6396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER PERMANENTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-02",
        "last_updated": "2015-07-02",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "ROBBIE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "GENETICS CLINICAL SERVICES MANAGER",
        "authorized_official_telephone_number": "510-752-6396",
        "authorized_official_credential": "MS, CGC"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Genetic Counselor, MS",
            "state": "CA",
            "license": "GC000653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

All providers in Oakland, CA · Genetic Counselor (M.S.) in California

Sources for this page

Verify at the official NPI Registry.