Active NPI
Sierra Prine
- Student in an Organized Health Care Education/Training Program
- San Leandro, CA
National Provider Identifier
1386479079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 2208 San Leandro Blvd
San Leandro, CA 94577-5957 - Phone
- (510) 483-6715
- NPI assigned
- Sep 4, 2024
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
2208 San Leandro Blvd
San Leandro, CA 94577-5957
Mailing address
1427 69TH Ave
Oakland, CA 94621-3456
Other practice location 1
111 Myrtle St Ste 102
Oakland, CA 94607-2535
Phone (510) 568-0306
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725408000000",
"number": "1386479079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1427 69TH AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946213456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2208 SAN LEANDRO BLVD",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945775957",
"telephone_number": "510-483-6715"
}
],
"practiceLocations": [
{
"address_1": "111 Myrtle St Ste 102",
"address_purpose": "LOCATION",
"city": "Oakland",
"state": "CA",
"postal_code": "946072535",
"country_code": "US",
"telephone_number": "510-568-0306",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PRINE",
"first_name": "SIERRA",
"sole_proprietor": "NO",
"sex": "U",
"enumeration_date": "2024-09-04",
"last_updated": "2024-09-04",
"certification_date": "2024-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.