Active NPI
Abraham K Stephen, RPH
- Pharmacist
- Vallejo, CA
National Provider Identifier
1639423460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 31655
- Practice address
- 774 Admiral Callaghan LN
Vallejo, CA 94591-3650 - Phone
- (707) 554-8060
- NPI assigned
- Oct 31, 2012
- Last updated
- Oct 31, 2012
- Sex
- Male
- 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 | 31655 | CA | Primary |
Addresses
Primary practice location
774 Admiral Callaghan LN
Vallejo, CA 94591-3650
Mailing address
5453 Victoria LN
El Sobrante, CA 94803-3832
Phone (510) 223-9748
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31655 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351641600000",
"number": "1639423460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5453 VICTORIA LN",
"city": "EL SOBRANTE",
"state": "CA",
"postal_code": "948033832",
"telephone_number": "510-223-9748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "774 ADMIRAL CALLAGHAN LN",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945913650",
"telephone_number": "707-554-8060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHEN",
"first_name": "ABRAHAM",
"middle_name": "K",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-31",
"last_updated": "2012-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "31655",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.