Individual provider Active NPI

Ali Arianjam

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Santa Rosa, CA
National Provider Identifier
1396222576
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
76901 Issued in CA
Practice address
401 Bicentennial Way
Santa Rosa, CA 95403-2149
Phone
(707) 393-4000
NPI assigned
Jul 20, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Pharmacist 1835X0200X 76901 CA
Ambulatory Care Pharmacist 1835P2201X 76901 CA
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 76901 CA Primary

Addresses

Primary practice location

401 Bicentennial Way
Santa Rosa, CA 95403-2149

Mailing address

2537 Barley LN
Santa Rosa, CA 95403-8708
Phone (909) 964-8835

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

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
76901CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1396222576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2537 BARLEY LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954038708",
            "telephone_number": "909-964-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BICENTENNIAL WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032149",
            "telephone_number": "707-393-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARIANJAM",
        "first_name": "ALI",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-20",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835X0200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Oncology",
            "state": "CA",
            "license": "76901",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "CA",
            "license": "76901",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CA",
            "license": "76901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "401 Bicentennial Way",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954032149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; 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.