Individual provider Active NPI

Star Blanca Roman

  • Community Health Registered Nurse
  • San Francisco, CA
National Provider Identifier
1689242216
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
9513991 Issued in CA
Practice address
333 Valencia St
San Francisco, CA 94103-3547
Phone
(628) 217-6759
NPI assigned
Jun 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 9513991 CA Primary

Addresses

Primary practice location

333 Valencia St
San Francisco, CA 94103-3547

Mailing address

220 Trinity Rd
Brisbane, CA 94005-1316
Phone (650) 307-0971

Other practice location 1

25 Van Ness Ave Ste 660
San Francisco, CA 94102-6057
Phone (650) 307-0971

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

LicenseStateTypeSpecialty
9513991CAMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1689242216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 TRINITY RD",
            "city": "BRISBANE",
            "state": "CA",
            "postal_code": "940051316",
            "telephone_number": "650-307-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 VALENCIA ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941033547",
            "telephone_number": "628-217-6759"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Van Ness Ave Ste 660",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941026057",
            "country_code": "US",
            "telephone_number": "650-307-0971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "STAR",
        "middle_name": "BLANCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "9513991",
            "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 Jun 10, 2021; 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.