Active NPI
Andrew Hearn
- Licensed Vocational Nurse
- San Leandro, CA
National Provider Identifier
1558021543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 703775
- Practice address
- 2050 Fairmont Dr
San Leandro, CA 94578-1001 - Phone
- (510) 895-5502
- Fax
- (510) 895-7407
- NPI assigned
- Dec 18, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 703775 | CA | Primary |
Addresses
Primary practice location
2050 Fairmont Dr
San Leandro, CA 94578-1001
Mailing address
2554 E 16TH St Apt 23
Oakland, CA 94601-1661
Phone (510) 355-7657
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
| License | State | Type | Specialty |
|---|---|---|---|
| 703775 | CA | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639785600000",
"number": "1558021543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2554 E 16TH ST APT 23",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946011661",
"telephone_number": "510-355-7657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2050 FAIRMONT DR",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945781001",
"telephone_number": "510-895-5502",
"fax_number": "510-895-7407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEARN",
"first_name": "ANDREW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-12-18",
"last_updated": "2021-12-18",
"certification_date": "2021-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "703775",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.