Individual provider Active NPI

Alysha Jinnah

  • Chiropractor
  • Concord, CA
National Provider Identifier
1477040384
Registry record updated Apr 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
33731 Issued in CA
Practice address
1290 Monument Blvd Ste B
Concord, CA 94520-4480
Phone
(925) 602-5000
Fax
(925) 602-5003
NPI assigned
Apr 16, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 33731 CA Primary

Addresses

Primary practice location

1290 Monument Blvd Ste B
Concord, CA 94520-4480

Mailing address

1290 Monument Blvd Ste B
Concord, CA 94520-4480
Phone (925) 602-5000

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

LicenseStateTypeSpecialty
33731CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Heidi E Olson Professional Chiro Corp Chiropractor PastSince Mar 22, 2018 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1477040384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 MONUMENT BLVD STE B",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945204480",
            "telephone_number": "925-602-5000",
            "fax_number": "925-602-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 MONUMENT BLVD STE B",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945204480",
            "telephone_number": "925-602-5000",
            "fax_number": "925-602-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JINNAH",
        "first_name": "ALYSHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-16",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "33731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; 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.