Active NPI
Theresa Abatayo, PHARMD
- Pharmacist
- Vallejo, CA
National Provider Identifier
1750845913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 72542
- Practice address
- 525 Oregon St
Vallejo, CA 94590-3201 - Phone
- (707) 648-2200
- NPI assigned
- Jan 22, 2019
- Last updated
- Sep 29, 2021
- 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 | 72542 | CA | Primary |
Addresses
Primary practice location
525 Oregon St
Vallejo, CA 94590-3201
Mailing address
300 Cogburn Circle
Vacaville, CA 95687
Phone (925) 470-0406
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 72542 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632873600000",
"number": "1750845913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 COGBURN CIRCLE",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "95687",
"telephone_number": "925-470-0406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 OREGON ST",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945903201",
"telephone_number": "707-648-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABATAYO",
"first_name": "THERESA",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-22",
"last_updated": "2021-09-29",
"certification_date": "2021-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "72542",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.