Active NPI
Lucy Concepcion Mitchell, RPH
- Pharmacist
- San Rafael, CA
National Provider Identifier
1750664744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH 32803
- Practice address
- 830 3Rd St
San Rafael, CA 94901-3302 - Phone
- (415) 455-9919
- Fax
- (415) 455-4532
- NPI assigned
- Sep 26, 2011
- Last updated
- Sep 26, 2011
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH 32803 | CA | Primary |
Addresses
Primary practice location
830 3Rd St
San Rafael, CA 94901-3302
Mailing address
2419 18TH Ave
San Francisco, CA 94116-2402
Phone (415) 759-1595
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RPH 33803 | Other | CA | BOARD OF PHARMACY |
Other names 1
- Mrs. Lucita Concepcion Balmediano
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH 32803 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316995200000",
"number": "1750664744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2419 18TH AVE",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941162402",
"telephone_number": "415-759-1595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 3RD ST",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949013302",
"telephone_number": "415-455-9919",
"fax_number": "415-455-4532"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONCEPCION MITCHELL",
"first_name": "LUCY",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-26",
"last_updated": "2011-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH 32803",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PHARMACY",
"identifier": "RPH 33803",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LUCITA",
"last_name": "BALMEDIANO",
"middle_name": "CONCEPCION",
"prefix": "MRS.",
"credential": "RPH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.