Unknown Individual – Psychiatry Physician, NPI 1093855181

Unknown Individual is a healthcare provider. based in Oakland, California. specializing in Psychiatry Physician. They hold a License No. G51846 (CA). The NPI Number for Unknown Individual is 1093855181

Main info

Organization
Inactive
44 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1093855181
Phone
(510) 777-3847
Address
7200 BANCROFT AVE
Deactivation Date
7 September 2021

Doctor Profile

Medical School Name
UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Secondary Phone
5102687837
Graduation Year
1982 (44 years ago)
PAC ID
8820989890
Group Practice PAC ID
9739070624
Professional Enrollment ID
I20040322000483
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 7200 BANCROFT AVE

    SUITE 125-A

    OAKLAND, CA 946052403

    Phone: (510) 777-3847

    Mailing address matches the actual address.

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.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

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 94605)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9739070624View full group profile

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1093855181?
NPI 1093855181 belongs to Unknown Individual; compare other details if you need extra assurance.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Psychiatry Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Oakland, California as the reference point for Unknown Individual, then confirm.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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