Active NPI
Jacqueline Richards, M.D.
- Internal Medicine Physician
- San Leandro, CA
National Provider Identifier
1467530212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- G58115
- Practice address
- 2500 Merced St
San Leandro, CA 94577-4201 - Phone
- (510) 454-1000
- NPI assigned
- Nov 1, 2006
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | G58115 | CA | Primary |
Addresses
Primary practice location
2500 Merced St
San Leandro, CA 94577-4201
Mailing address
2500 Merced St
San Leandro, CA 94577-4201
Phone (510) 454-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G581150 | Medicaid | CA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432252800000",
"number": "1467530212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 MERCED ST",
"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 ST",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945774201",
"telephone_number": "510-454-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDS",
"first_name": "JACQUELINE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2015-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "G58115",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G581150",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.