Active NPI
Amy Eliassieh
- Student in an Organized Health Care Education/Training Program
- Cherryland, CA
National Provider Identifier
1396656302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 494 Blossom Way
Cherryland, CA 94541-1948 - Phone
- (510) 582-7676
- NPI assigned
- Sep 16, 2026
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | CA | Primary |
Addresses
Primary practice location
494 Blossom Way
Cherryland, CA 94541-1948
Mailing address
2210 Durant Ave Unit 5
Berkeley, CA 94704-1534
Phone (510) 582-7676
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1789516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789516800000",
"number": "1396656302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2210 DURANT AVE UNIT 5",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947041534",
"telephone_number": "510-582-7676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "494 BLOSSOM WAY",
"city": "CHERRYLAND",
"state": "CA",
"postal_code": "945411948",
"telephone_number": "510-582-7676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELIASSIEH",
"first_name": "AMY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-09-16",
"last_updated": "2026-09-16",
"certification_date": "2026-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cherryland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.