Active NPI
Jeeae Sophie Hwang, R.D.
- Pediatric Nutrition Registered Dietitian
- San Leandro, CA
National Provider Identifier
1619009255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nutrition Registered Dietitian
- Practice address
- 2500 Merced St
San Leandro, CA 94577-4201 - Phone
- (510) 454-3438
- NPI assigned
- Mar 9, 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 |
|---|---|---|---|---|
| Pediatric Nutrition Registered Dietitian | 133VN1004X | Primary |
Addresses
Primary practice location
2500 Merced St
San Leandro, CA 94577-4201
Mailing address
2500 Merced Street
Nutrition Services Department
San Leandro, CA 94577
Phone (510) 454-3438
Other names 1
- Ms. Jee Ae Hwang
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) |
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": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639958400000",
"number": "1619009255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 MERCED STREET",
"address_2": "NUTRITION SERVICES DEPARTMENT",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "94577",
"telephone_number": "510-454-3438",
"fax_number": "510-752-6550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 MERCED ST",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945774201",
"telephone_number": "510-454-3438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HWANG",
"first_name": "JEEAE",
"middle_name": "SOPHIE",
"name_prefix": "Ms.",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-09",
"last_updated": "2021-12-20",
"certification_date": "2021-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "2500 Merced St",
"city": "San Leandro",
"state": "CA",
"country_code": "US",
"postal_code": "945774201",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JEE AE",
"last_name": "HWANG",
"prefix": "MS.",
"credential": "R.D.",
"code": "5",
"type": "Other Name"
}
]
}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 20, 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.