Individual provider Active NPI

Araba Sackey, FNP

  • Family Nurse Practitioner
  • Anaheim, CA
National Provider Identifier
1093235699
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95004382 Issued in CA
Practice address
1091 S Matthew Way
Anaheim, CA 92808-1459
Phone
(714) 348-5631
Fax
(714) 348-5631
NPI assigned
Jun 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F1216615 CA
Family Nurse Practitioner 363LF0000X 95004382 CA Primary

Addresses

Primary practice location

1091 S Matthew Way
Anaheim, CA 92808-1459

Mailing address

1091 S Matthew Way
Anaheim, CA 92808-1459
Phone (714) 348-5631

Other practice location 1

802 Magnolia Ave
Corona, CA 92879-3104
Phone (714) 348-5631

Other identifiers 1

IdentifierTypeStateIssuer
821305518OtherCACALIFORNIA SECRETARY OF STATE

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
95004382CAMDFamily Nurse Practitioner
F1216615CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Medic CurrentSince Jul 24, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1093235699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1091 S MATTHEW WAY",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928081459",
            "telephone_number": "714-348-5631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1091 S MATTHEW WAY",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928081459",
            "telephone_number": "714-348-5631",
            "fax_number": "714-348-5631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "802 Magnolia Ave",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "CA",
            "postal_code": "928793104",
            "country_code": "US",
            "telephone_number": "714-348-5631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SACKEY",
        "first_name": "ARABA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "F1216615",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95004382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA SECRETARY OF STATE",
            "identifier": "821305518",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.