Active NPI
Mallory Frances Elizabeth Loomis, BSN RN
- Registered Nurse
- Oakland, CA
National Provider Identifier
1437739612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 95156654
- Practice address
- 2730 Adeline St
Oakland, CA 94607-2408 - Phone
- (510) 981-4100
- NPI assigned
- Apr 12, 2021
- Last updated
- Feb 9, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 95156654 | CA | Primary |
Addresses
Primary practice location
2730 Adeline St
Oakland, CA 94607-2408
Mailing address
3924 Ardley Ave Rear Suite
Oakland, CA 94602-1615
Phone (925) 437-5466
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
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95156654 | CA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644364800000",
"number": "1437739612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3924 ARDLEY AVE REAR SUITE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946021615",
"telephone_number": "925-437-5466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2730 ADELINE ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946072408",
"telephone_number": "510-981-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOOMIS",
"first_name": "MALLORY",
"middle_name": "FRANCES ELIZABETH",
"credential": "BSN RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-12",
"last_updated": "2022-02-09",
"certification_date": "2022-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "95156654",
"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 Feb 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.