Individual provider Active NPI

Deepa Pulickal

  • Pharmacist
  • Oakland, CA
National Provider Identifier
1477954592
Registry record updated Sep 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH62407 Issued in CA
Practice address
8400 Edgewater Dr
Oakland, CA 94621-1468
Phone
(510) 430-9723
NPI assigned
Sep 8, 2014
Last updated
Sep 8, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH62407 CA Primary

Addresses

Primary practice location

8400 Edgewater Dr
Oakland, CA 94621-1468

Mailing address

8400 Edgewater Dr
Oakland, CA 94621-1468
Phone (510) 430-9723

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
RPH62407CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410134400000",
    "number": "1477954592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 EDGEWATER DR",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946211468",
            "telephone_number": "510-430-9723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 EDGEWATER DR",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946211468",
            "telephone_number": "510-430-9723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULICKAL",
        "first_name": "DEEPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2014-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH62407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 8, 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.