Active NPI
Madeline C Rafferty
- Student in an Organized Health Care Education/Training Program
- Oakland, CA
National Provider Identifier
1801510631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 117851
- Practice address
- 3301 E 12TH St
Oakland, CA 94601-3424 - Phone
- (510) 269-9030
- NPI assigned
- Sep 26, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 117851 | ||
| Student in an Organized Health Care Education/Training Program | 390200000X | 117851 | CA | Primary |
Addresses
Primary practice location
3301 E 12TH St
Oakland, CA 94601-3424
Mailing address
5835 Colton Blvd
Oakland, CA 94611-2204
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 |
|---|---|---|---|
| 117851 | CA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693440000000",
"number": "1801510631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5835 COLTON BLVD",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946112204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3301 E 12TH ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946013424",
"telephone_number": "510-269-9030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAFFERTY",
"first_name": "MADELINE",
"middle_name": "C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-26",
"last_updated": "2023-08-31",
"certification_date": "2023-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": "117851",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "117851",
"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 Aug 31, 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.