Individual provider Active NPI

Tizita Tadesse Tekletsadik

  • Student in an Organized Health Care Education/Training Program
  • Oakland, CA
National Provider Identifier
1386576932
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
554 Grand Ave
Oakland, CA 94610-3515
Phone
(510) 444-1671
Fax
(510) 373-2495
NPI assigned
May 29, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

554 Grand Ave
Oakland, CA 94610-3515

Mailing address

1919 Ygnacio Valley Rd Apt 52
Walnut Creek, CA 94598-3292
Phone (510) 434-4638

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

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Empowering Refugees & Immigrants PastSince Jul 21, 2024 Accepting new patients
Center for Empowering Refugees and Immigrants PastSince May 14, 2023 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1780012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1386576932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 YGNACIO VALLEY RD APT 52",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983292",
            "telephone_number": "510-434-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 GRAND AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946103515",
            "telephone_number": "510-444-1671",
            "fax_number": "510-373-2495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKLETSADIK",
        "first_name": "TIZITA",
        "middle_name": "TADESSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-29",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "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 Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; 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.