Individual provider Active NPI

Skylar Loeb, RN, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Oakland, CA
National Provider Identifier
1821344003
Registry record updated May 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
23607 Issued in CA
Practice address
616 16TH St
Oakland, CA 94612-1205
Phone
(510) 981-4100
NPI assigned
Jul 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 802200 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 23607 CA Primary

Addresses

Primary practice location

616 16TH St
Oakland, CA 94612-1205

Mailing address

616 16TH St
Oakland, CA 94612-1205
Phone (510) 981-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190823003309 CA Practitioner - Nurse Practitioner 6507194891 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
23607CAMDCertified Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelong Medical Care CurrentSince Jun 17, 2019 Accepting new patients
Lifelong Medical Care CurrentSince Jun 17, 2019 Accepting new patients

Locations

2344 6th St
Berkeley, CA 94710
Phone (510) 981-3203

10700 MacArthur Blvd
Ste 14B
Oakland, CA 94605
Phone (510) 563-4300

616 16th St
Oakland, CA 94612
Phone (510) 451-1273

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462320000000",
    "number": "1821344003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 16TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121205",
            "telephone_number": "510-981-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 16TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121205",
            "telephone_number": "510-981-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOEB",
        "first_name": "SKYLAR",
        "credential": "RN, NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-25",
        "last_updated": "2016-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "802200",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "23607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.