Individual provider Active NPI

Daniel Mickleburgh, LVN

  • Licensed Vocational Nurse
  • Oakland, CA
National Provider Identifier
1821540923
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
227010 Issued in CA
Practice address
10850 Macarthur Blvd Ste 200
Oakland, CA 94605-5266
Phone
(925) 286-6598
NPI assigned
Oct 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 227010 CA Primary

Addresses

Primary practice location

10850 Macarthur Blvd Ste 200
Oakland, CA 94605-5266

Mailing address

10850 Macarthur Blvd Ste 200
Oakland, CA 94605-5266
Phone (925) 286-6598

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
227010CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1821540923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10850 MACARTHUR BLVD STE 200",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946055266",
            "telephone_number": "925-286-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10850 MACARTHUR BLVD STE 200",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946055266",
            "telephone_number": "925-286-6598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKLEBURGH",
        "first_name": "DANIEL",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-25",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "227010",
            "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 25, 2016; 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.