Individual provider Active NPI

Jenna Roat, MFTINTERN

  • Student in an Organized Health Care Education/Training Program
  • Oakland, CA
National Provider Identifier
1891162855
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
#IMF84180 Issued in CA
Practice address
5297 College Ave
Oakland, CA 94618-1462
Phone
(510) 898-6553
NPI assigned
Aug 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X #IMF84180 CA Primary

Addresses

Primary practice location

5297 College Ave
Oakland, CA 94618-1462

Mailing address

45 Carl St
San Francisco, CA 94117-3917
Phone (415) 969-1512

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
#IMF84180CAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1891162855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 CARL ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941173917",
            "telephone_number": "415-969-1512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5297 COLLEGE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181462",
            "telephone_number": "510-898-6553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROAT",
        "first_name": "JENNA",
        "credential": "MFTINTERN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-25",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "#IMF84180",
            "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 Aug 25, 2015; 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.