NPIMap

Organization Active NPI

Preventive Care Network Medical Services, Inc.

Doing business as James a Watson Wellness Center Medical Clinic

  • Specialist
  • Oakland, CA
National Provider Identifier
1467878363
Registry record updated Mar 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
C41403 Issued in CA
Legal business name
PREVENTIVE CARE NETWORK MEDICAL SERVICES, INC.
Doing business as
James a Watson Wellness Center Medical Clinic
Practice address
5709 Market St
Oakland, CA 94608-2811
Phone
(510) 444-9460
Fax
(510) 444-9461
NPI assigned
Mar 16, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2014

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

Authorized official

Name
Dr. Henry Geoffrey Watson, M.D.NPI 1235142894
Title
Chief Executive Officer
Phone
(510) 444-9460

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X C41403 CA Primary

Addresses

Primary practice location

5709 Market St
Oakland, CA 94608-2811

Mailing address

5709 Market St
Oakland, CA 94608-2811
Phone (510) 444-9460

Other names 1

  • JAMES A WATSON WELLNESS CENTER MEDICAL CLINIC Doing business as

National Provider Directory

National Provider Directory

Locations

2450 Ashby Ave
Berkeley, CA 94705
Phone (510) 204-1566

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1394928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394928000000",
    "number": "1467878363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5709 MARKET ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946082811",
            "telephone_number": "510-444-9460",
            "fax_number": "510-444-9461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5709 MARKET ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946082811",
            "telephone_number": "510-444-9460",
            "fax_number": "510-444-9461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTIVE CARE NETWORK MEDICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-16",
        "last_updated": "2014-03-16",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "GEOFFREY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "510-444-9460",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "C41403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JAMES A WATSON WELLNESS CENTER MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 16, 2014; 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.