Active NPI
Kenneth Gordon Tyeskey
- Counselor
- Hayward, CA
National Provider Identifier
1487153771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 22505 Woodroe Ave
Hayward, CA 94541-3410 - Phone
- (510) 653-5040
- NPI assigned
- Feb 2, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
22505 Woodroe Ave
Hayward, CA 94541-3410
Mailing address
PO Box 248
Elk Grove, CA 95759-0248
Phone (916) 203-8743
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524528000000",
"number": "1487153771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 248",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957590248",
"telephone_number": "916-203-8743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22505 WOODROE AVE",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945413410",
"telephone_number": "510-653-5040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYESKEY",
"first_name": "KENNETH",
"middle_name": "GORDON",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-02",
"last_updated": "2018-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hayward, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.