Active NPI
Fredrick R. Andres
- Registered Nurse
- Oakland, CA
National Provider Identifier
1780194241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 719771
- Practice address
- 280 17TH St
Oakland, CA 94612-4124 - Phone
- (510) 352-9890
- Fax
- (510) 352-9891
- NPI assigned
- Oct 10, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 719771 | CA | Primary |
Addresses
Primary practice location
280 17TH St
Oakland, CA 94612-4124
Mailing address
280 17TH St
Oakland, CA 94612-4124
Phone (510) 352-9890
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
| License | State | Type | Specialty |
|---|---|---|---|
| 719771 | CA | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507593600000",
"number": "1780194241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 17TH ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946124124",
"telephone_number": "510-352-9890",
"fax_number": "510-352-9981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "280 17TH ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946124124",
"telephone_number": "510-352-9890",
"fax_number": "510-352-9891"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDRES",
"first_name": "FREDRICK",
"middle_name": "R.",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-10",
"last_updated": "2017-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "719771",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.