Individual provider Active NPI

Roberta Ramona Carrubba, LVN

  • Licensed Vocational Nurse
  • Sacramento, CA
National Provider Identifier
1053416891
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
VN58142 Issued in CA
Practice address
7171 Bowling Dr
Suite 300 South City Health Center DHHS
Sacramento, CA 95823
Phone
(916) 875-0802
Fax
(916) 876-5857
NPI assigned
Sep 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X VN58142 CA Primary

Addresses

Primary practice location

7171 Bowling Dr
Suite 300 South City Health Center DHHS
Sacramento, CA 95823

Mailing address

1453 Sherwood Ave
Sacramento, CA 95822
Phone (916) 875-0802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
VN58142CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053416891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1453 SHERWOOD AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95822",
            "telephone_number": "916-875-0802",
            "fax_number": "916-876-5857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7171 BOWLING DR",
            "address_2": "SUITE 300 SOUTH CITY HEALTH CENTER DHHS",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95823",
            "telephone_number": "916-875-0802",
            "fax_number": "916-876-5857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRUBBA",
        "first_name": "ROBERTA",
        "middle_name": "RAMONA",
        "name_prefix": "Miss",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN58142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.