Individual provider Active NPI

Selome W Tensaye

  • Licensed Vocational Nurse
  • Oakland, CA
National Provider Identifier
1407698244
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
252662 Issued in CA
Practice address
510 17TH St
Oakland, CA 94612-1553
Phone
(510) 433-1150
NPI assigned
Jun 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 252662 CA Primary

Addresses

Primary practice location

510 17TH St
Oakland, CA 94612-1553

Mailing address

2002 Ward St
Berkeley, CA 94703-2238
Phone (510) 575-6154

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
252662CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1407698244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 WARD ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947032238",
            "telephone_number": "510-575-6154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 17TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121553",
            "telephone_number": "510-433-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENSAYE",
        "first_name": "SELOME",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "252662",
            "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 Jun 12, 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.

Verify at the official NPI Registry.