Eli Vickery
Student in an Organized Health Care Education/Training Program in Berkeley, CA. Individual provider (NPI-1).
Details
- NPI
- 1245065010
- Entity type
- Individual (NPI-1)
- Name
- Eli Vickery
- Sole proprietor
- Yes
- Enumeration date
- Sep 3, 2024
- Certification date
- Sep 3, 2024
- Last updated
- Sep 3, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
2130 Center St Ste 200Berkeley, CA 94704-1386
Phone 510-548-8283 · Fax 510-548-2938
Mailing address
2130 Center St Ste 200Berkeley, CA 94704-1386
Phone 510-548-8283 · Fax 510-548-2938
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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