Alice Jean Benham, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN498229 NP10994 Issued in CA

Practice address

350 30TH St
Suite 530
Oakland, CA 94609-3424

Phone

(510) 839-0584

Fax

(510) 839-1692

NPI assigned

Jan 8, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• The West Oakland Health Council

  dba Baywell Health

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1285754234
  Medicare reassignment NPD
• The West Oakland Health Council

  dba Baywell Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Oakland, CA
  • NPI 1043331630
  NPD

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578611570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 36TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946092811",
            "telephone_number": "510-654-7078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 30TH ST",
            "address_2": "SUITE 530",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093424",
            "telephone_number": "510-839-0584",
            "fax_number": "510-839-1692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENHAM",
        "first_name": "ALICE",
        "middle_name": "JEAN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "RN498229 NP10994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hugh M. Benedict, MD
• Tara Deanna Benesch, MD, MS
• Maren Elisabeth Benevento, LCSW
• Ava Benezra
• Kate Benham-Suk, M.D.
• Charles Benin
• Cheryle Benin
• Destiny M Benin
• Shannel Benisano, LMFT
• Monica Benitez Hernandez

• Family Nurse Practitioner in Oakland, CA
• Providers in Oakland, CA by specialty
• Family 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.