Active NPI
Ioulia A Matyssik, RN
- Registered Nurse
- Redwood City, CA
National Provider Identifier
1063543304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 693359
- Practice address
- 541 Jefferson Ave
Suite 202
Redwood City, CA 94063-1739 - Phone
- (650) 817-9070
- Fax
- (650) 817-9074
- NPI assigned
- Mar 8, 2007
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 693359 | CA | Primary |
Addresses
Primary practice location
541 Jefferson Ave
Suite 202
Redwood City, CA 94063-1739
Mailing address
1080 Marina Village Parkway
Suite 100
Alameda, CA 94501
Phone (510) 747-0527
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 693359 | CA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063543304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1080 MARINA VILLAGE PARKWAY",
"address_2": "SUITE 100",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "94501",
"telephone_number": "510-747-0527",
"fax_number": "510-337-7969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "541 JEFFERSON AVE",
"address_2": "SUITE 202",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940631739",
"telephone_number": "650-817-9070",
"fax_number": "650-817-9074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATYSSIK",
"first_name": "IOULIA",
"middle_name": "A",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "693359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redwood City, 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.