Doris Therese Crisostomo Untalan, C.N.M.

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

NMW 1079 Issued in CA

Practice address

2500 Merced Street
San Leandro, CA 94577-4201

Phone

(510) 454-1000

NPI assigned

Nov 27, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Doris Therese Crisostomo Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1457427940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MERCED STREET",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774201",
            "telephone_number": "510-454-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MERCED STREET",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774201",
            "telephone_number": "510-454-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNTALAN",
        "first_name": "DORIS THERESE",
        "middle_name": "CRISOSTOMO",
        "name_prefix": "Mrs.",
        "credential": "C.N.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "NMW 1079",
            "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": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2500 Merced St",
            "city": "San Leandro",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DORIS",
            "last_name": "CRISOSTOMO",
            "middle_name": "THERESE",
            "prefix": "MISS",
            "credential": "CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christiana Umeh
• Gennifer Unell, PHARMD
• Soriya Mariana Ung-Koy
• Nancy Ung, D.M.D., M.P.H., MSD
• Shari T. Unitan, LMFT
• Dominique Omozele Unubun
• Lauren Urbanski
• Lizeth Ureno
• Tawny Ureta
• Jennifer N Uribe-Sanchez

• Advanced Practice Midwife in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Advanced Practice Midwife in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.