Active NPI
Emily Jane Medeiros, PHARMD
- Pharmacist
- Oakland, CA
National Provider Identifier
1619476348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 77576
- Practice address
- 350 Hawthorne Ave
Oakland, CA 94609-3108 - Phone
- (510) 655-4000
- NPI assigned
- Feb 8, 2018
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 77576 | CA | Primary |
Addresses
Primary practice location
350 Hawthorne Ave
Oakland, CA 94609-3108
Mailing address
1299 Lloyd Thayer Cir
Stockton, CA 95206-5503
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77576 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518048000000",
"number": "1619476348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1299 LLOYD THAYER CIR",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952065503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 HAWTHORNE AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946093108",
"telephone_number": "510-655-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDEIROS",
"first_name": "EMILY",
"middle_name": "JANE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-08",
"last_updated": "2018-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "77576",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.