Individual provider Active NPI

Aliceanne Thondu

  • Family Nurse Practitioner
  • Redding, CA
National Provider Identifier
1063087047
Registry record updated May 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95017260 Issued in CA
Practice address
1035 Placer St
Redding, CA 96001-1170
Phone
(530) 246-5710
NPI assigned
May 23, 2021
Last updated
May 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95017260 CA Primary

Addresses

Primary practice location

1035 Placer St
Redding, CA 96001-1170

Mailing address

5463 Clermont CT
Westlake Village, CA 91362-7173
Phone (619) 663-7293

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221205001035 CA Practitioner - Nurse Practitioner 0547639114 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shasta Community Health Center Current Accepting new patients
Shasta Community Health Center CurrentSince Oct 1, 2022 Accepting new patients
Shasta Community Health Center CurrentSince Oct 1, 2022 Accepting new patients

Locations

1035 Placer St
Redding, CA 96001

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1621728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621728000000",
    "number": "1063087047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5463 CLERMONT CT",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913627173",
            "telephone_number": "619-663-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 PLACER ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011170",
            "telephone_number": "530-246-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THONDU",
        "first_name": "ALICEANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-23",
        "last_updated": "2021-05-23",
        "certification_date": "2021-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.