Active NPI
Bonnitta Kidd
- Counselor
- Oakland, CA
National Provider Identifier
1922209014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 3301 E 12TH St Ste 259
Oakland, CA 94601-2940 - Phone
- (510) 269-9030
- NPI assigned
- May 29, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
3301 E 12TH St Ste 259
Oakland, CA 94601-2940
Mailing address
610 E 18TH St Apt H
Oakland, CA 94606-2439
Phone (510) 241-7965
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Second Chance Tri-Cities Center | Past | 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.
-
- Community/Behavioral Health Agency
- Newark, CA
- NPI 1336341098
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633996800000",
"number": "1922209014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 E 18TH ST APT H",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946062439",
"telephone_number": "510-241-7965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3301 E 12TH ST STE 259",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946012940",
"telephone_number": "510-269-9030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDD",
"first_name": "BONNITTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-29",
"last_updated": "2021-10-12",
"certification_date": "2021-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"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 Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.