Individual provider Active NPI

Edemel Pareno

  • Registered Nurse
  • Union City, CA
National Provider Identifier
1770046955
Registry record updated Apr 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
766901 Issued in CA
Practice address
3072 San Mateo Way
Union City, CA 94587-2817
Phone
(510) 366-5503
NPI assigned
Apr 13, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 766901 CA Primary

Addresses

Primary practice location

3072 San Mateo Way
Union City, CA 94587-2817

Mailing address

9903 Gable Ridge Ter Apt B
Rockville, MD 20850-4633

Other practice location 1

9903 Gable Ridge Ter Apt B
Rockville, MD 20850-4633
Phone (510) 366-5503

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

State licenses

LicenseStateTypeSpecialty
766901CAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555113600000",
    "number": "1770046955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9903 GABLE RIDGE TER APT B",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3072 SAN MATEO WAY",
            "city": "UNION CITY",
            "state": "CA",
            "postal_code": "945872817",
            "telephone_number": "510-366-5503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9903 Gable Ridge Ter Apt B",
            "address_purpose": "LOCATION",
            "city": "Rockville",
            "state": "MD",
            "postal_code": "208504633",
            "country_code": "US",
            "telephone_number": "510-366-5503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARENO",
        "first_name": "EDEMEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-13",
        "last_updated": "2019-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "766901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2019; 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.