Active NPI
Pamela Maxine Odendahl-Quant, MFT
- Case Manager/Care Coordinator
- Fremont, CA
National Provider Identifier
1689854564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- MFC 24064
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| MFC 24064 | CA | MD | Case Manager/Care Coordinator |
| MFC 24065 | CA | MD | Case Manager/Care Coordinator |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Case Management Agency
- Fremont, CA
- NPI 1306184734
-
- Case Management Agency
- Fremont, CA
- NPI 1467882563
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.