Oteria Randall Koayen

Primary specialty

Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X

License

15439 Issued in CA

Practice address

1166 Brooktrail Dr
1900 Fruitvale Ave Suite 3E
Pittsburg, CA 94565-7627

Phone

(925) 261-9953

NPI assigned

Jun 14, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Oteria Randall Koayen Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Health Care for the Homeless

  • Chore Provider
  • Oakland, CA
  • NPI 1932252053
  NPD (past)

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508060237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1166 BROOKTRAIL DR",
            "city": "PITTSBURG",
            "state": "CA",
            "postal_code": "945657627",
            "telephone_number": "925-261-9953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1166 BROOKTRAIL DR",
            "address_2": "1900 FRUITVALE AVE SUITE 3E",
            "city": "PITTSBURG",
            "state": "CA",
            "postal_code": "945657627",
            "telephone_number": "925-261-9953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL KOAYEN",
        "first_name": "OTERIA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "CA",
            "license": "15439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OTERIA",
            "last_name": "KOAYEN",
            "middle_name": "RANDALL",
            "credential": "FNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Shalina D Raj
• Genesis Arely Ramirez, MSC, PPSC, AMFT
• Jessica Yamili Ramirez, MSW
• Caralyn S Ramos, MS, PPS
• Nicole Natalie Ranahan
• Devon Layshene Rankin
• Ruth Cristiana Rauca, DDS
• Alma Brittany Ray, SUDRC
• Sanjay Ray, M.D.
• Jyotsana P. Raygor, MD

• Critical Care Medicine Nurse Practitioner in Pittsburg, CA
• Providers in Pittsburg, CA by specialty
• Critical Care Medicine Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.