MR. SHAREEF NASHID SALAAM (NPI# 1124673173) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124673173 |
| Entity Type | Individual |
| Full Name | MR. SHAREEF NASHID SALAAM |
| Practice Address |
747 52nd St Oakland CA 94609-1809 |
| Mailing Address |
590 El Dorado Ave Unit 215 Oakland CA 94611-5071 |
| Practice Telephone | 5104283885 |
| Practice Fax Number | 5109860541 |
| Mailing Telephone | 5102901471 |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2019-08-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers | ||
| N | 103TS0200X |
Psychologist Specialization: School |
Behavioral Health & Social Service Providers |
| Street Address |
747 52ND ST |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-1809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942200928 | James Philip Riddel Jr. | Nurse Practitioner | 747 52nd St, Oakland, CA 94609-1809 | 2005-07-29 |
| 1235739905 | Maria Elena Alicia Valdivia Fortuna | Social Worker | 747 52nd St, Oakland, CA 94609-1809 | 2020-10-30 |
| 1295342707 | Jenny Chen | Dietitian, Registered | 747 52nd St, Oakland, CA 94609-1809 | 2020-09-29 |
| 1104433028 | Phuong T Nguyen-tran | Pharmacist | 747 52nd St, Oakland, CA 94609-1809 | 2020-09-24 |
| 1114538899 | Ji Yun Lee | Student in an Organized Health Care Education/Training Program | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-14 |
| 1780295857 | Luis Alonso Perez Jr. | Social Worker | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-12 |
| 1255941803 | Aleesia Renta-ramirez | Student in an Organized Health Care Education/Training Program | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-07 |
| 1831709773 | Carroll Taylor Brown IIi | Registered Nurse | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-05 |
| 1053921064 | Jessica Stankiewicz Lightcap | Registered Nurse | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-04 |
| 1184242307 | Cecilia Fairley | Genetic Counselor, MS | 747 52nd St, Oakland, CA 94609-1809 | 2020-07-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
| 1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
| 1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
| 1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
| 1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
| 1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
| 1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
| 1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
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| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285813493 | Claire Ellen Craig | Psychologist | 10901 Macarthur Blvd, 202, Oakland, CA 94605-5200 | 2007-10-24 |
| 1952469173 | Nina Rudnick | Psychologist | 738 Alcatraz Ave, #1, Oakland, CA 94609-1040 | 2006-12-04 |
| 1386208569 | Thao-chau T Trinh | Psychologist | 444 Hegenberger Rd, Oakland, CA 94621-1418 | 2019-04-24 |
| 1487125480 | John Moore IIi | Psychologist | 1000 Broadway Ste 460, Oakland, CA 94607-4033 | 2018-12-17 |
| 1942564133 | Judith Wan | Psychologist | 3301 E 12th St Ste 259, Oakland, CA 94601-2940 | 2012-07-02 |
| 1326301227 | Herminia Hernandez | Psychologist | 5275 Claremont Ave, Oakland, CA 94618-1032 | 2012-06-17 |
| 1023339157 | James De Quinto | Psychologist | 5236 Claremont Ave Fl 2, Oakland, CA 94618-1033 | 2010-06-11 |
| 1841423332 | Melanie R Clemons | Psychologist | 470 27th St, Bawar, Oakland, CA 94612-2413 | 2009-08-31 |
| 1801029624 | Wei Ki Elsie Chan | Psychologist | 747 52nd St, Oakland, CA 94609-1809 | 2009-08-27 |
| 1639355613 | Debbara J Monroe | Psychologist | 505 14th St, Suite 900, Oakland, CA 94612-1406 | 2008-01-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.