Active NPI
John O Mohammadioun
- Student in an Organized Health Care Education/Training Program
- Berkeley, CA
National Provider Identifier
1710274774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 3075 Adeline St
102
Berkeley, CA 94703-2576 - Phone
- (510) 848-1112
- NPI assigned
- Jun 28, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
3075 Adeline St
102
Berkeley, CA 94703-2576
Mailing address
3075 Adeline St
102
Berkeley, CA 94703-2576
Phone (510) 848-1112
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 29, 2024 through Apr 29, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anxiety Specialists of Atlanta LLC | Past | 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.
-
- Community/Behavioral Health Agency
- Dunwoody, GA
- NPI 1083291512
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475020800000",
"number": "1710274774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3075 ADELINE ST",
"address_2": "102",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947032576",
"telephone_number": "510-848-1112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3075 ADELINE ST",
"address_2": "102",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947032576",
"telephone_number": "510-848-1112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHAMMADIOUN",
"first_name": "JOHN",
"middle_name": "O",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-28",
"last_updated": "2016-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.