Individual provider Active NPI

Charles L. Tatum II

  • Counselor
  • San Francisco, CA
National Provider Identifier
1588083141
Registry record updated Apr 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
1153 Oak St
San Francisco, CA 94117-2216
Phone
(415) 431-9000
Fax
(415) 431-6527
NPI assigned
Apr 10, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

1153 Oak St
San Francisco, CA 94117-2216

Mailing address

1153 Oak St
San Francisco, CA 94117-2216
Phone (415) 431-9000

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": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397088000000",
    "number": "1588083141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1153 OAK ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941172216",
            "telephone_number": "415-431-9000",
            "fax_number": "415-431-6527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1153 OAK ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941172216",
            "telephone_number": "415-431-9000",
            "fax_number": "415-431-6527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "CHARLES",
        "middle_name": "L.",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-10",
        "last_updated": "2014-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2014; 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.