Individual provider Active NPI

Gillyn Maung

  • Student in an Organized Health Care Education/Training Program
  • San Leandro, CA
National Provider Identifier
1902411564
Registry record updated Aug 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
101 Callan Ave Ste 400
San Leandro, CA 94577-4523
Phone
(844) 828-2254
NPI assigned
Sep 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Community Health Worker 172V00000X

Addresses

Primary practice location

101 Callan Ave Ste 400
San Leandro, CA 94577-4523

Mailing address

101 Callan Ave Ste 400
San Leandro, CA 94577-4523
Phone (844) 828-2254

Other practice location 1

368 Fell St
San Francisco, CA 94102-5144
Phone (415) 861-0828 ext. 134

Other practice location 2

52 Dore St
San Francisco, CA 94103-3828
Phone (415) 861-0828 ext. 132

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maru PastSince Sep 8, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756598400000",
    "number": "1902411564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CALLAN AVE STE 400",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774523",
            "telephone_number": "844-828-2254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CALLAN AVE STE 400",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774523",
            "telephone_number": "844-828-2254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "368 Fell St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941025144",
            "country_code": "US",
            "telephone_number": "415-861-0828 x134",
            "fax_number": "415-861-0140",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "52 Dore St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941033828",
            "country_code": "US",
            "telephone_number": "415-861-0828 x132",
            "fax_number": "415-861-0140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAUNG",
        "first_name": "GILLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2025-08-31",
        "certification_date": "2025-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2025; 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.