Active NPI
Yasaman Masoudi
- Pharmacist
- Moraga, CA
National Provider Identifier
1962068882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 70079
- Practice address
- 1480 Moraga Rd Ste D
Moraga, CA 94556-2005 - Phone
- (925) 376-5166
- NPI assigned
- May 15, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 70079 | CA | Primary |
Addresses
Primary practice location
1480 Moraga Rd Ste D
Moraga, CA 94556-2005
Mailing address
4290 El Nido Ranch Rd
Orinda, CA 94563-1909
Phone (707) 334-5559
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
| License | State | Type | Specialty |
|---|---|---|---|
| 70079 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Store California LLC | 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.
-
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- Kapolei, HI
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557878400000",
"number": "1962068882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4290 EL NIDO RANCH RD",
"city": "ORINDA",
"state": "CA",
"postal_code": "945631909",
"telephone_number": "707-334-5559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1480 MORAGA RD STE D",
"city": "MORAGA",
"state": "CA",
"postal_code": "945562005",
"telephone_number": "925-376-5166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASOUDI",
"first_name": "YASAMAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-15",
"last_updated": "2019-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "70079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moraga, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.