Individual provider Active NPI

Nicamer Tolentino

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Roseville, CA
National Provider Identifier
1740930445
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Practice address
1224 Coloma Way
Roseville, CA 95661-4601
Phone
(408) 385-6677
NPI assigned
Mar 25, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X CA Primary

Addresses

Primary practice location

1224 Coloma Way
Roseville, CA 95661-4601

Mailing address

1224 Coloma Way
Roseville, CA 95661-4601
Phone (408) 385-6677

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

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Care Group, Inc. PastSince Mar 27, 2022 Accepting new patients
Unity Care Group, Inc PastSince Mar 27, 2022 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": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1740930445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 COLOMA WAY",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614601",
            "telephone_number": "408-385-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 COLOMA WAY",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614601",
            "telephone_number": "408-385-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLENTINO",
        "first_name": "NICAMER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-25",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.