Individual provider Active NPI

Asma Raoufizadeh, PHARMD

  • Pharmacist
  • San Jose, CA
National Provider Identifier
1821731217
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
85567 Issued in CA
Practice address
4110 N 1St St
San Jose, CA 95134-1513
Phone
(408) 434-1839
NPI assigned
Apr 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 85567 CA Primary

Addresses

Primary practice location

4110 N 1St St
San Jose, CA 95134-1513

Mailing address

4110 N 1St St
San Jose, CA 95134-1513
Phone (408) 434-1839

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
85567CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Garfield Beach CVS LLC PastSince Jun 12, 2022 Accepting new patients
Garfield Beach CVS, L.L.C. PastSince Jun 12, 2022 Accepting new patients
Longs Drug Store California LLC PastSince Apr 1, 2022 Accepting new patients
Longs Drug Stores California LLC PastSince Apr 1, 2022 Accepting new patients

Organizations & group practices 4

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": "1649894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1821731217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 N 1ST ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951341513",
            "telephone_number": "408-434-1839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 N 1ST ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951341513",
            "telephone_number": "408-434-1839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAOUFIZADEH",
        "first_name": "ASMA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-14",
        "last_updated": "2022-06-06",
        "certification_date": "2022-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "85567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.