Active NPI
Daynetta Bernstine
- Substance Abuse Rehabilitation Facility
- Richmond, CA
National Provider Identifier
1396194346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Abuse Rehabilitation Facility
- License
- R112861214
- Practice address
- 311 W Macdonald Ave
Richmond, CA 94801-2965 - Phone
- (510) 838-6924
- NPI assigned
- Jun 10, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | R112861214 | CA | Primary |
Addresses
Primary practice location
311 W Macdonald Ave
Richmond, CA 94801-2965
Mailing address
311 W Macdonald Ave
Richmond, CA 94801-2965
Phone (510) 838-6924
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A1833801 | Medicaid | CA |
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 |
|---|---|---|---|
| R112861214 | CA | MD | Substance Abuse Rehabilitation Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465516800000",
"number": "1396194346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 W MACDONALD AVE",
"city": "RICHMOND",
"state": "CA",
"postal_code": "948012965",
"telephone_number": "510-838-6924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 W MACDONALD AVE",
"city": "RICHMOND",
"state": "CA",
"postal_code": "948012965",
"telephone_number": "510-838-6924"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERNSTINE",
"first_name": "DAYNETTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-10",
"last_updated": "2016-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": "CA",
"license": "R112861214",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "A1833801",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richmond, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.