Jevari Anderson, is a
Student In An Organized Health Care Education/training Program based in Oakland, California. Jevari Anderson is licensed to practice in California (license number ) and his current practice location is
747 52nd St, Oakland, California. He can be reached at his office (for appointments etc.) via phone at
(510) 428-3885.
NPI number for Jevari Anderson is 1417670944 and his current mailing address is 57 Madrid Ln, Antioch, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1417670944.
Healthcare Provider's Profile
| Full Name | Jevari Anderson |
|---|
| Gender | Male |
|---|
| Speciality | Student In An Organized Health Care Education/training Program |
|---|
| Location | 747 52nd St, Oakland, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1417670944
- Provider Enumeration Date: 09/20/2022
- Last Update Date: 08/12/2025
Medical Identifiers
Medical identifiers for Jevari Anderson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1417670944 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 172V00000X | Community Health Worker | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jevari Anderson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jevari Anderson,
57 Madrid Ln,
Antioch, CA 94509-4455
Ph: (510) 650-7156 | Jevari Anderson,
747 52nd St,
Oakland, CA 94609-1809
Ph: (510) 428-3885 |
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