Joseph Jacob Mazzullo, PMHNP

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

666305 Issued in CA

Practice address

8329 Brimhall Road
Suite 804
Bakersfield, CA 93312-2243

Phone

(661) 431-1555

Fax

(661) 471-2410

NPI assigned

Aug 25, 2018

Sex

Male

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arise Psychiatric Medical Group IncGroup PAC ID 6709286677, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Arise Psychiatric Medical Group Inc

  • Child & Adolescent Psychiatry Physician
  • Bakersfield, CA
  • NPI 1972183648
  Medicare reassignment Care Compare group NPD
• Kern Psychiatric Health and Wellness Center Inc

  • Psychiatry Physician
  • Bakersfield, CA
  • NPI 1962917021
  Medicare reassignment NPD
• Pacific Health Education Cognitive Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bakersfield, CA
  • NPI 1487121133
  Medicare reassignment NPD
• Pacific Coast Psychiatric Associates Inc

  • Clinical Psychologist
  • Scottsdale, AZ
  • NPI 1023125465
  NPD (past)

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

{
    "created_epoch": "1535155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1023599230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10748",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933890748",
            "telephone_number": "661-431-1555",
            "fax_number": "661-471-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8329 BRIMHALL ROAD",
            "address_2": "SUITE 804",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933122243",
            "telephone_number": "661-431-1555",
            "fax_number": "661-471-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZULLO",
        "first_name": "JOSEPH",
        "middle_name": "JACOB",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-25",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "666305",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "666305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VETERANS ADMINISTRATION",
            "identifier": "1149863059",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carlos Humberto Mazariegos Letran, M.D.
• Bongani Peter Mazibuko
• Rosemary W Mazur
• Mazzeo Medical Corporation
• Armi Lynn Mazzeo, M.D.
• Sabrina Patricia Mbaba
• Melanie Tracy MC Cann, RD
• Victoria MC Clain
• Susan McArthur
• Albert McBride, MD

• Registered Nurse in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.