Samaritan House

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

License

220000275 Issued in CA

Legal business name

SAMARITAN HOUSE

Practice address

19 W 39TH Ave
San Mateo, CA 94403-4593

Phone

(650) 578-0400

Fax

(650) 578-0440

NPI assigned

Oct 25, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Jason Wong, MD

Title

Medical Director

Phone

(650) 257-5286

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Graciela Maria Arevalo, DNP, FNP, RN

  • Family Nurse Practitioner
  • San Mateo, CA
  • NPI 1871477885
  NPD (past)
• Sahar Aurangzeb, DDS

  • General Practice Dentistry
  • San Mateo, CA
  • NPI 1497099253
  NPD (past)
• Farzaneh Raoufi, FNP

  • Primary Care Nurse Practitioner
  • San Mateo, CA
  • NPI 1710106737
  NPD (past)

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477353600000",
    "number": "1891247847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4031 PACIFIC BLVD",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944034666",
            "telephone_number": "650-341-4081",
            "fax_number": "650-341-0526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 W 39TH AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944034593",
            "telephone_number": "650-578-0400",
            "fax_number": "650-578-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-25",
        "last_updated": "2016-10-25",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "650-257-5286",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": "220000275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelley Ruth Salpeter, MD
• Francesca Victoria Luna Salud
• Catherine Ann Salvador
• Shenna Samaniego, NP
• Megan Lambert Samara
• Evrade T Same
• Samir Nanjapa DDS, a Dental Corporation
• Janal Ann Sampang
• Felicia Rene Samprath
• Elyse Casey Samuels, LCSW

• Community Health Clinic/Center in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Community Health Clinic/Center in California

• 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.