Active NPI
Sydnie Black
- Recreation Therapist
- Livermore, CA
National Provider Identifier
1467328641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 80390
- Practice address
- 2441 Constitution Dr
Livermore, CA 94551-7573 - Phone
- (925) 505-4700
- NPI assigned
- Oct 14, 2025
- 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 |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 80390 | CA | Primary |
Addresses
Primary practice location
2441 Constitution Dr
Livermore, CA 94551-7573
Mailing address
510 17TH St
Oakland, CA 94612-1553
Phone (510) 433-1150
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
| License | State | Type | Specialty |
|---|---|---|---|
| 80390 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1760400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761264000000",
"number": "1467328641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "510 17TH ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946121553",
"telephone_number": "510-433-1150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2441 CONSTITUTION DR",
"city": "LIVERMORE",
"state": "CA",
"postal_code": "945517573",
"telephone_number": "925-505-4700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "SYDNIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-10-14",
"last_updated": "2025-10-24",
"certification_date": "2025-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "CA",
"license": "80390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livermore, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.