Individual provider Active NPI

Anna Fastenko, CCH

  • Homeopath
  • San Jose, CA
National Provider Identifier
1437313608
Registry record updated Jul 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
HomeopathTaxonomy code 175L00000X
License
231249209 Issued in CA
Practice address
4020 Moorpark Ave
Suite 108
San Jose, CA 95117-4102
Phone
(408) 380-3020
NPI assigned
Jul 16, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Homeopath 175L00000X 231249209 CA Primary

Addresses

Primary practice location

4020 Moorpark Ave
Suite 108
San Jose, CA 95117-4102

Mailing address

4020 Moorpark Ave
Suite 108
San Jose, CA 95117-4102
Phone (408) 380-3020

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
231249209CAMDHomeopath

NPI Registry JSON

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216166400000",
    "number": "1437313608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 MOORPARK AVE",
            "address_2": "SUITE 108",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951174102",
            "telephone_number": "408-380-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 MOORPARK AVE",
            "address_2": "SUITE 108",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951174102",
            "telephone_number": "408-380-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASTENKO",
        "first_name": "ANNA",
        "credential": "CCH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-16",
        "last_updated": "2008-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175L00000X",
            "taxonomy_group": "",
            "desc": "Homeopath",
            "state": "CA",
            "license": "231249209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; 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.