Avalon Skin Care and Electrolysis Inc

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

AVALON SKIN CARE AND ELECTROLYSIS INC

Practice address

430 Peninsula Ave Ste 8
San Mateo, CA 94401-1683

Phone

(650) 344-5555

NPI assigned

Dec 5, 2018

Last updated

Dec 6, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

AVALON SKIN CARE AND ELECTROLYSIS INCAs reported in NPPES

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

Authorized official

Name

Ms. Gemma Roche, ELECTROLYSISTNPI 1790256550

Title

Owner/Operator

Phone

(650) 344-5555

Specialties & licenses 1

Addresses

Part of

Avalon Skin Care and Electrolysis Inc

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gemma Margaret Mary Roche

  • Specialist
  • San Mateo, CA
  • NPI 1790256550
  NPD (past) Authorized official

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

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544054400000",
    "number": "1598236358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 PENINSULA AVE STE 8",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944011683",
            "telephone_number": "650-344-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 PENINSULA AVE STE 8",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944011683",
            "telephone_number": "650-344-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON SKIN CARE AND ELECTROLYSIS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AVALON SKIN CARE AND ELECTROLYSIS INC",
        "enumeration_date": "2018-12-05",
        "last_updated": "2018-12-06",
        "status": "A",
        "authorized_official_last_name": "ROCHE",
        "authorized_official_first_name": "GEMMA",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "650-344-5555",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ELECTROLYSIST"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sahar Aurangzeb, DDS
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• Julie Averill, OTR
• Kristine Averilla
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• Angela Avila

• Specialist in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; 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.