Active NPI
Caroline Samiezade-Yazd
- Religious Nonmedical Nursing Personnel
- Oakland, CA
National Provider Identifier
1679761597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Religious Nonmedical Nursing Personnel
- License
- 711726
- Practice address
- 411 30TH St
#314
Oakland, CA 94609-3301 - Phone
- (510) 273-4200
- NPI assigned
- Oct 4, 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 |
|---|---|---|---|---|
| Religious Nonmedical Nursing Personnel | 374T00000X | 711726 | CA | Primary |
Addresses
Primary practice location
411 30TH St
#314
Oakland, CA 94609-3301
Mailing address
5674 Stoneridge Dr
# 116
Pleasanton, CA 94588-8500
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 711726 | CA | MD | Religious Nonmedical Nursing Personnel |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191456000000",
"number": "1679761597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5674 STONERIDGE DR",
"address_2": "# 116",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "945888500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 30TH ST",
"address_2": "#314",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946093301",
"telephone_number": "510-273-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMIEZADE-YAZD",
"first_name": "CAROLINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-04",
"last_updated": "2007-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "374T00000X",
"taxonomy_group": "",
"desc": "Religious Nonmedical Nursing Personnel",
"state": "CA",
"license": "711726",
"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 Oct 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.