Fatemeh A Tavakkoly

Primary specialty

PharmacistTaxonomy code 183500000X

License

60517 Issued in CA

Practice address

1720 S Bascom Ave
Campbell, CA 95008-0608

Phone

(408) 371-7191

NPI assigned

Jul 1, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Longs Drug Store California LLC

  • Pharmacy
  • Kapolei, HI
  • NPI 1700565793
  NPD (past)

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1962064840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15800 SHANNON RD",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950325724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 S BASCOM AVE",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950080608",
            "telephone_number": "408-371-7191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "821 The Alameda",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951263156",
            "country_code": "US",
            "telephone_number": "408-291-4553",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "821 The Alameda",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951263156",
            "country_code": "US",
            "telephone_number": "408-921-4553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAVAKKOLY",
        "first_name": "FATEMEH",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "60517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lita Angelina Tangitau, ASW
• Joseph Alexander Tansek, MA, LMFT
• Jesse Joseph Tarango
• Denise Ardythe Tarasuk, R.N. N.D.
• Tatyana V. Borodulin MD, Inc
• Myra Emma Tavira
• Donald Paul Taylor, ACSW
• Kelli Taylor, PSYD
• Peter Hill Taylor, O.D.
• Likang Te

• Pharmacist in Campbell, CA
• Providers in Campbell, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; 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.