Individual provider Active NPI

Lakeida Masters

  • Student in an Organized Health Care Education/Training Program
  • Oakland, CA
National Provider Identifier
1639742091
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
390 40TH St
Oakland, CA 94609-2633
Phone
(510) 653-5040
NPI assigned
Jul 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Counselor 101Y00000X

Addresses

Primary practice location

390 40TH St
Oakland, CA 94609-2633

Mailing address

390 40TH St
Oakland, CA 94609-2633
Phone (510) 653-5040

Other practice location 1

1122 E Leland Rd Apt 151
Pittsburg, CA 94565-7512
Phone (510) 253-3529

Other identifiers 1

IdentifierTypeStateIssuer
1411033663MedicaidCA

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": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1639742091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 40TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946092633",
            "telephone_number": "510-653-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 40TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946092633",
            "telephone_number": "510-653-5040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1122 E Leland Rd Apt 151",
            "address_purpose": "LOCATION",
            "city": "Pittsburg",
            "state": "CA",
            "postal_code": "945657512",
            "country_code": "US",
            "telephone_number": "510-253-3529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASTERS",
        "first_name": "LAKEIDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1411033663",
            "state": "CA"
        }
    ],
    "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 Jun 6, 2024; 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.