Individual provider Active NPI

Elizabeth Serra, DC

  • Nutrition Chiropractor
  • San Francisco, CA
National Provider Identifier
1669522439
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
DC22847 Issued in CA
Practice address
2460 Mission St
Suite 203
San Francisco, CA 94110-2467
Phone
(415) 282-8989
Fax
(415) 550-1313
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X DC22847 CA Primary

Addresses

Primary practice location

2460 Mission St
Suite 203
San Francisco, CA 94110-2467

Mailing address

2460 Mission St
Suite 203
San Francisco, CA 94110-2467
Phone (415) 282-8989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070629000361 CA Practitioner - Chiropractic 0143329250 Practice locations: Oakland, CA; San Francisco, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC22847CAMDNutrition Chiropractor
22847CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Fishkin Chiropractic, a Professional Corporation PastSince Jun 15, 2010 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669522439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 MISSION ST",
            "address_2": "SUITE 203",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102467",
            "telephone_number": "415-282-8989",
            "fax_number": "415-550-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 MISSION ST",
            "address_2": "SUITE 203",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102467",
            "telephone_number": "415-282-8989",
            "fax_number": "415-550-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRA",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "CA",
            "license": "DC22847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.