Active NPI
Lea Navarez Glick, ANP
- Adult Health Nurse Practitioner
- Emeryville, CA
National Provider Identifier
1376814251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 19954
- Practice address
- 4560 Horton St
Emeryville, CA 94608-2916 - Phone
- (510) 923-3526
- NPI assigned
- Jan 24, 2012
- Last updated
- Jan 24, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 19954 | CA | Primary |
Addresses
Primary practice location
4560 Horton St
Emeryville, CA 94608-2916
Mailing address
4560 Horton St
Emeryville, CA 94608-2916
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
| License | State | Type | Specialty |
|---|---|---|---|
| 19954 | CA | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327363200000",
"number": "1376814251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4560 HORTON ST",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "946082916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4560 HORTON ST",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "946082916",
"telephone_number": "510-923-3526"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLICK",
"first_name": "LEA",
"middle_name": "NAVAREZ",
"name_prefix": "Ms.",
"credential": "ANP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-24",
"last_updated": "2012-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "CA",
"license": "19954",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Emeryville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.