Individual provider Active NPI

Gladys M Nulph, VN211003

  • Health Maintenance Organization
  • Fremont, CA
National Provider Identifier
1902138597
Registry record updated Feb 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
VN211003 Issued in CA
Practice address
2296 Country Dr
Fremont, CA 94536-5315
Phone
(510) 608-3733
NPI assigned
Feb 5, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X VN211003 CA Primary

Addresses

Primary practice location

2296 Country Dr
Fremont, CA 94536-5315

Mailing address

849 Blossom Way
Hayward, CA 94541-2003
Phone (925) 245-1385

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
VN211003CAMDHealth Maintenance Organization

NPI Registry JSON

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

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265328000000",
    "number": "1902138597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 BLOSSOM WAY",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945412003",
            "telephone_number": "925-245-1385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2296 COUNTRY DR",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945365315",
            "telephone_number": "510-608-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NULPH",
        "first_name": "GLADYS",
        "middle_name": "M",
        "credential": "VN211003",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-05",
        "last_updated": "2010-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "VN211003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2010; 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.