Individual provider Active NPI

Pamela Maxine Odendahl-Quant, MFT

  • Case Manager/Care Coordinator
  • Fremont, CA
National Provider Identifier
1689854564
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
MFC 24064 Issued in CA
Practice address
588 Brown Rd
Fremont, CA 94539-7011
Phone
(510) 252-0910
Fax
(510) 252-0428
NPI assigned
Nov 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X MFC 24065 CA
Case Manager/Care Coordinator 171M00000X MFC 24064 CA Primary

Addresses

Primary practice location

588 Brown Rd
Fremont, CA 94539-7011

Mailing address

2395 West Avenue 136TH
San Leandro, CA 94577-4152
Phone (510) 252-0910

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
MFC 24064CAMDCase Manager/Care Coordinator
MFC 24065CAMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Abode Services Past Accepting new patients
Abode Services Past Accepting new patients

Organizations & group practices 2

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": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1689854564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2395 WEST AVENUE 136TH",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774152",
            "telephone_number": "510-252-0910",
            "fax_number": "510-252-0428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "588 BROWN RD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945397011",
            "telephone_number": "510-252-0910",
            "fax_number": "510-252-0428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODENDAHL-QUANT",
        "first_name": "PAMELA",
        "middle_name": "MAXINE",
        "name_prefix": "Mrs.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-08",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "MFC 24065",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "MFC 24064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.

Verify at the official NPI Registry.