Active NPI
Mary Alexandra Masek
- Student in an Organized Health Care Education/Training Program
- Vallejo, CA
National Provider Identifier
1093311151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 174H00000X
- Practice address
- 321 Lighthouse Dr
Vallejo, CA 94590-4005 - Phone
- (714) 767-7904
- NPI assigned
- Dec 4, 2020
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 174H00000X | CA | Primary |
Addresses
Primary practice location
321 Lighthouse Dr
Vallejo, CA 94590-4005
Mailing address
321 Lighthouse Dr
Vallejo, CA 94590-4005
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 |
|---|---|---|---|
| 174H00000X | CA | MD | Health Educator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607040000000",
"number": "1093311151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "321 LIGHTHOUSE DR",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945904005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "321 LIGHTHOUSE DR",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945904005",
"telephone_number": "714-767-7904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASEK",
"first_name": "MARY",
"middle_name": "ALEXANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-04",
"last_updated": "2020-12-04",
"certification_date": "2020-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "174H00000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.