Mechelle Renee Perea-Ryan, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP9455 Issued in CA

Practice address

1717 Las Vegas St
Modesto, CA 95358-5500

Phone

(209) 576-4200

Fax

(209) 556-5064

NPI assigned

Jan 15, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mechelle Renee Perea Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323993600000",
    "number": "1023255841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 W CHILDS AVE",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953416805",
            "telephone_number": "209-383-1848",
            "fax_number": "209-383-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 LAS VEGAS ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953585500",
            "telephone_number": "209-576-4200",
            "fax_number": "209-556-5064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREA-RYAN",
        "first_name": "MECHELLE",
        "middle_name": "RENEE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-15",
        "last_updated": "2011-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN445148",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP9455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "NP9455",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MECHELLE",
            "last_name": "PEREA",
            "middle_name": "RENEE",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amanda L Peoples, NP
• Maribel Peral-Ramirez, LCSW
• Georgina Judith Peraza
• Regina C Perdomo
• Robert Perdue
• Steven Peretiatko, MD
• Carmel Perez Andrade
• Jessica Yuliana Perez Arauza
• Laura Perez Barragan
• Darielys Perez Collantes

• Family Nurse Practitioner in Modesto, CA
• Providers in Modesto, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.