Individual provider Active NPI

Isiah Daniels, CADC-II

  • Substance Abuse Rehabilitation Facility
  • San Rafael, CA
National Provider Identifier
1386156560
Registry record updated Oct 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
A018660515 Issued in CA
Practice address
710 C St Ste 8
San Rafael, CA 94901-3853
Phone
(451) 485-6736
NPI assigned
Oct 28, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X A018660515 CA Primary

Addresses

Primary practice location

710 C St Ste 8
San Rafael, CA 94901-3853

Mailing address

710 N 6TH St
San Jose, CA 95112-3277
Phone (831) 124-0527

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
A018660515CAMDSubstance Abuse Rehabilitation Facility

NPI Registry JSON

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

{
    "created_epoch": "1509148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509148800000",
    "number": "1386156560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N 6TH ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951123277",
            "telephone_number": "831-124-0527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 C ST STE 8",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013853",
            "telephone_number": "451-485-6736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "ISIAH",
        "name_prefix": "Mr.",
        "credential": "CADC-II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-28",
        "last_updated": "2017-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "A018660515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2017; 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.