Active NPI
Dana Gayle Fries
- Licensed Vocational Nurse
- Redding, CA
National Provider Identifier
1053815365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 687254
- Practice address
- 1090 E Cypress Ave Ste B
Redding, CA 96002-1163 - Phone
- (530) 223-2332
- Fax
- (530) 223-4721
- NPI assigned
- Mar 21, 2018
- Last updated
- Mar 21, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 687254 | CA | Primary |
Addresses
Primary practice location
1090 E Cypress Ave Ste B
Redding, CA 96002-1163
Mailing address
1705 El Cerrito Dr
Red Bluff, CA 96080-4055
Phone (530) 200-6285
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000000 | Other | NONE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 687254 | CA | MD | Licensed Vocational Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prac Holdings, Inc. | Past | Accepting new patients | |
| Arcaida Home Care & Staffing | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Illness Intermediate Care Facility
- Redding, CA
- NPI 1639547896
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521590400000",
"number": "1053815365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1705 EL CERRITO DR",
"city": "RED BLUFF",
"state": "CA",
"postal_code": "960804055",
"telephone_number": "530-200-6285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1090 E CYPRESS AVE STE B",
"city": "REDDING",
"state": "CA",
"postal_code": "960021163",
"telephone_number": "530-223-2332",
"fax_number": "530-223-4721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIES",
"first_name": "DANA",
"middle_name": "GAYLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-21",
"last_updated": "2018-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "687254",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NONE",
"identifier": "0000000",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.