Unknown Individual – Psychiatry Physician, NPI 1013019116

Unknown Individual is a healthcare provider. based in Alameda, California. specializing in Psychiatry Physician. They hold a License No. 22128 (AZ). The NPI Number for Unknown Individual is 1013019116

Main info

Organization
Inactive
54 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1013019116
Phone
(510) 525-4381
Address
450 PARK ST
Deactivation Date
8 February 2023

Doctor Profile

Medical School Name
STANFORD UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5105254381
Graduation Year
1972 (54 years ago)
PAC ID
7911899109
Professional Enrollment ID
I20040324001756
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 450, Park Street, South Shore, Alameda, Alameda County, California, 94501, United States

    SUITE 101

    ALAMEDA, CA 945016295

    Phone: (510) 525-4381

    Type: Location

  • 776, Haight Avenue, Woodstock, Alameda, Alameda County, California, 94501, United States

    ALAMEDA, CA 945013312

    Phone: (510) 525-4381

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 94501)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1013019116 — is the standard way to identify this listing.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Psychiatry Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Alameda, California as a primary anchor for Unknown Individual unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.