Individual provider Active NPI

Khizer Sadique Subhani

  • Registered Nurse
  • Redwood City, CA
National Provider Identifier
1801308358
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95142707 Issued in CA
Practice address
1410 Marshall St
Redwood City, CA 94063-2503
Phone
(650) 393-0777
NPI assigned
Oct 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X 95142707 CA
Psychiatric/Mental Health Registered Nurse 163WP0808X 95142707 CA
Registered Nurse 163W00000X 95142707 CA Primary

Addresses

Primary practice location

1410 Marshall St
Redwood City, CA 94063-2503

Mailing address

411 Borel Ave Ste 101
San Mateo, CA 94402-3525
Phone (650) 372-4080

Other practice location 1

1234 Empire St
Fairfield, CA 94533-5711
Phone (707) 439-7830

Other practice location 2

950 W Julian St
San Jose, CA 95126-2719
Phone (408) 292-9353

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
95142707CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1801308358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 BOREL AVE STE 101",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944023525",
            "telephone_number": "650-372-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 MARSHALL ST",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940632503",
            "telephone_number": "650-393-0777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1234 Empire St",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CA",
            "postal_code": "945335711",
            "country_code": "US",
            "telephone_number": "707-439-7830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "950 W Julian St",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951262719",
            "country_code": "US",
            "telephone_number": "408-292-9353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUBHANI",
        "first_name": "KHIZER",
        "middle_name": "SADIQUE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-24",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "CA",
            "license": "95142707",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95142707",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95142707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.