NPIMap

Organization Active NPI

Schuman-Liles Clinic, Inc

  • Psychiatry Physician
  • Oakland, CA
National Provider Identifier
1861568909
Registry record updated Mar 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SCHUMAN-LILES CLINIC, INC
Practice address
10850 Macarthur Blvd Ste 300
Oakland, CA 94605-5266
Phone
(510) 569-9334
Fax
(510) 569-9334
NPI assigned
Nov 28, 2006
Last updated
Mar 10, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2016

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

Authorized official

Name
Mr. LJ Jennings
Title
Ceo
Phone
(510) 569-9334

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

10850 Macarthur Blvd Ste 300
Oakland, CA 94605-5266

Mailing address

10850 Macarthur Blvd Ste 300
Oakland, CA 94605-5266
Phone (510) 569-9334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000795 CA Part B Supplier - Clinic/Group Practice 1153234240 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
Practice locations: Oakland, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

10850 MacArthur Blvd
Ste 300
Oakland, CA 94605
Phone (510) 569-9334

433 Callan Ave
Ste 101
San Leandro, CA 94577
Phone (510) 355-7551

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457568000000",
    "number": "1861568909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10850 MACARTHUR BLVD STE 300",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946055266",
            "telephone_number": "510-569-9334",
            "fax_number": "510-569-9334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10850 MACARTHUR BLVD STE 300",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946055266",
            "telephone_number": "510-569-9334",
            "fax_number": "510-569-9334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHUMAN-LILES CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2016-03-10",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "LJ",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "510-569-9334",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "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 Mar 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.