Organization Active NPI

Araeofphreshair LLC

Doing business as Phresh Air LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • San Jose, CA
National Provider Identifier
1720736440
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
ARAEOFPHRESHAIR LLC
Doing business as
Phresh Air LLC
Practice address
1165 Lincoln Ave # 1887
San Jose, CA 95125-3043
Phone
(408) 372-8580
NPI assigned
Mar 11, 2022
Last updated
Mar 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Authorized official

Name
Raven Amelia Cross, PMHNPNPI 1114596624
Title
Ceo
Phone
(408) 372-8580

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

1165 Lincoln Ave # 1887
San Jose, CA 95125-3043

Mailing address

1165 Lincoln Ave # 1887
San Jose, CA 95125-3043

Other names 1

  • Phresh Air LLC Doing business as

National Provider Directory

National Provider Directory

Locations

1165 Lincoln Ave
#1887
San Jose, CA 95125
Phone (408) 372-8580

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1646956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646956800000",
    "number": "1720736440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 LINCOLN AVE # 1887",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951253043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 LINCOLN AVE # 1887",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951253043",
            "telephone_number": "408-372-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARAEOFPHRESHAIR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-11",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "RAVEN",
        "authorized_official_middle_name": "AMELIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "408-372-8580",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phresh Air LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.