Active NPI
Janice Cecile Prudhomme, D.O.
- Preventive Medicine/Occupational Environmental Medicine Physician
- Oakland, CA
National Provider Identifier
1548313331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Preventive Medicine/Occupational Environmental Medicine Physician
- License
- 20 A6146
- Practice address
- 3100 Telegraph Ave
Suite #4100
Oakland, CA 94609-3210 - Phone
- (510) 869-8920
- Fax
- (510) 869-6903
- NPI assigned
- Jan 18, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Preventive Medicine/Occupational Environmental Medicine Physician | 2083P0500X | 20 A6146 | CA | Primary |
Addresses
Primary practice location
3100 Telegraph Ave
Suite #4100
Oakland, CA 94609-3210
Mailing address
26 Arlmont Dr
Kensington, CA 94707-1004
Phone (510) 559-8076
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20 A6146 | CA | MD | Preventive Medicine/Occupational Environmental Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1548313331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 ARLMONT DR",
"city": "KENSINGTON",
"state": "CA",
"postal_code": "947071004",
"telephone_number": "510-559-8076",
"fax_number": "510-559-8076"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 TELEGRAPH AVE",
"address_2": "SUITE #4100",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946093210",
"telephone_number": "510-869-8920",
"fax_number": "510-869-6903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUDHOMME",
"first_name": "JANICE",
"middle_name": "CECILE",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0500X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
"state": "CA",
"license": "20 A6146",
"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 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.