Active NPI
Deidra Flanagan
- Student in an Organized Health Care Education/Training Program
- Antioch, CA
National Provider Identifier
1730632183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 3856 Osprey Dr
Antioch, CA 94509-6473 - Phone
- (925) 565-2761
- NPI assigned
- Aug 2, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
3856 Osprey Dr
Antioch, CA 94509-6473
Mailing address
2400 Shady Willow LN Unit 24C
Brentwood, CA 94513-3730
Phone (925) 565-2761
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475625600000",
"number": "1730632183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 SHADY WILLOW LN UNIT 24C",
"city": "BRENTWOOD",
"state": "CA",
"postal_code": "945133730",
"telephone_number": "925-565-2761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3856 OSPREY DR",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945096473",
"telephone_number": "925-565-2761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLANAGAN",
"first_name": "DEIDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-02",
"last_updated": "2016-10-05",
"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 Antioch, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.