Provider Demographics
NPI:1144623729
Name:INCIARDI, JAMES PATRICK (RRT-NPS, EMT-P)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PATRICK
Last Name:INCIARDI
Suffix:
Gender:M
Credentials:RRT-NPS, EMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 BAHAMA REEF
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94949-5305
Mailing Address - Country:US
Mailing Address - Phone:415-309-5934
Mailing Address - Fax:
Practice Address - Street 1:3801 MIRANDA AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1207
Practice Address - Country:US
Practice Address - Phone:650-493-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-26
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAP22038146L00000X
CA35956227900000X
KS1437862279P3900X
CA00843251376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No2279P3900XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredNeonatal/Pediatrics
No376K00000XNursing Service Related ProvidersNurse's Aide