Active NPI
Elana Antolin-Wilczek
- Student in an Organized Health Care Education/Training Program
- Hayward, CA
National Provider Identifier
1760146815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 24301 Southland Dr Ste 300
Hayward, CA 94545-1546 - Phone
- (510) 300-3570
- Fax
- (877) 992-0038
- NPI assigned
- Oct 25, 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
24301 Southland Dr Ste 300
Hayward, CA 94545-1546
Mailing address
1165 Excelsior Ave
Oakland, CA 94610-2828
Phone (805) 452-8665
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": "1635120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721001600000",
"number": "1760146815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1165 EXCELSIOR AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946102828",
"telephone_number": "805-452-8665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24301 SOUTHLAND DR STE 300",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945451546",
"telephone_number": "510-300-3570",
"fax_number": "877-992-0038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTOLIN-WILCZEK",
"first_name": "ELANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-25",
"last_updated": "2024-07-15",
"certification_date": "2024-07-15",
"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 Hayward, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.