Active NPI
Tiklat Elyeh Janvisloo, CEO
- Driver
- Turlock, CA
National Provider Identifier
1821840414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- Y2961859
- Practice address
- 1325 Berry Dr
Turlock, CA 95382-0701 - Phone
- (209) 559-4600
- NPI assigned
- Apr 5, 2024
- Last updated
- Apr 5, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | Y2961859 | CA | Primary |
Addresses
Primary practice location
1325 Berry Dr
Turlock, CA 95382-0701
Mailing address
1325 Berry Dr
Turlock, CA 95382-0701
Phone (209) 559-4600
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 |
|---|---|---|---|
| Y2961859 | CA | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712275200000",
"number": "1821840414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1325 BERRY DR",
"city": "TURLOCK",
"state": "CA",
"postal_code": "953820701",
"telephone_number": "209-559-4600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1325 BERRY DR",
"city": "TURLOCK",
"state": "CA",
"postal_code": "953820701",
"telephone_number": "209-559-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELYEH JANVISLOO",
"first_name": "TIKLAT",
"credential": "CEO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-04-05",
"last_updated": "2024-04-05",
"certification_date": "2024-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "CA",
"license": "Y2961859",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Turlock, CA
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- Jordan Elola
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- Jordan Elzie
- Emanuel Medical Center
- Emanuel Medical Center, Inc. (Hospice of Emanuel)
- Emanuel Medical Center, Inc. (Emanuel Specialty Care - Cardiovascular Medicine)
- Emanuel Medical Center, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.