Individual provider Active NPI

Mark Edward Vaccarino

  • Psychiatric/Mental Health Nurse Practitioner
  • West Hills, CA
National Provider Identifier
1083563480
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
679765 Issued in CA
Practice address
7926 Kentland Ave
West Hills, CA 91304-4608
Phone
(203) 887-0560
NPI assigned
Jan 27, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 679765 CA Primary

Addresses

Primary practice location

7926 Kentland Ave
West Hills, CA 91304-4608

Mailing address

7926 Kentland Ave
West Hills, CA 91304-4608
Phone (203) 887-0560

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
679765CAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1769472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1083563480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7926 KENTLAND AVE",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913044608",
            "telephone_number": "203-887-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7926 KENTLAND AVE",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913044608",
            "telephone_number": "203-887-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACCARINO",
        "first_name": "MARK",
        "middle_name": "EDWARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-27",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "679765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; 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.