Active NPI
Khadijah Lightfoot, D.C.
- Chiropractor
- Emeryville, CA
National Provider Identifier
1780919753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 31404
- Practice address
- 3811 San Pablo Ave
Emeryville, CA 94608-3804 - Phone
- (510) 918-8574
- Fax
- (510) 969-8801
- NPI assigned
- Oct 8, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 31404 | CA | Primary |
Addresses
Primary practice location
3811 San Pablo Ave
Emeryville, CA 94608-3804
Mailing address
3811 San Pablo Ave
Emeryville, CA 94608-3804
Phone (510) 918-8574
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31404 | CA | MD | Licensed Psychiatric Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486339200000",
"number": "1780919753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3811 SAN PABLO AVE",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "946083804",
"telephone_number": "510-918-8574",
"fax_number": "510-969-8801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3811 SAN PABLO AVE",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "946083804",
"telephone_number": "510-918-8574",
"fax_number": "510-969-8801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIGHTFOOT",
"first_name": "KHADIJAH",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-08",
"last_updated": "2017-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "31404",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Emeryville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.