Active NPI
Samuel Caruso
- Speech-Language Pathologist
- Oakland, CA
National Provider Identifier
1972227080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 34042
- Practice address
- 2361 E 29TH St
Oakland, CA 94606-3511 - Phone
- (510) 488-0420
- NPI assigned
- Oct 3, 2022
- Last updated
- Oct 3, 2022
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 34042 | CA | Primary |
Addresses
Primary practice location
2361 E 29TH St
Oakland, CA 94606-3511
Mailing address
2361 E 29TH St
Oakland, CA 94606-3511
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 |
|---|---|---|---|
| 34042 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664755200000",
"number": "1972227080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2361 E 29TH ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946063511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2361 E 29TH ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946063511",
"telephone_number": "510-488-0420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARUSO",
"first_name": "SAMUEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-03",
"last_updated": "2022-10-03",
"certification_date": "2022-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "34042",
"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 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.