Active NPI
Lynda Diane Perino, RN PHN
- Registered Nurse
- Modesto, CA
National Provider Identifier
1104008853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 320906
- Practice address
- 830 Scenic Dr
BLDG 3 RM 7
Modesto, CA 95350-6131 - Phone
- (209) 652-1618
- Fax
- (209) 558-8315
- NPI assigned
- Dec 4, 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 | 320906 | CA | Primary |
Addresses
Primary practice location
830 Scenic Dr
BLDG 3 RM 7
Modesto, CA 95350-6131
Mailing address
PO Box 3127
Modesto, CA 95353-3127
Phone (209) 652-1618
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 |
|---|---|---|---|
| 320906 | CA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196726400000",
"number": "1104008853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3127",
"city": "MODESTO",
"state": "CA",
"postal_code": "953533127",
"telephone_number": "209-652-1618",
"fax_number": "209-558-8315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 SCENIC DR",
"address_2": "BLDG 3 RM 7",
"city": "MODESTO",
"state": "CA",
"postal_code": "953506131",
"telephone_number": "209-652-1618",
"fax_number": "209-558-8315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERINO",
"first_name": "LYNDA",
"middle_name": "DIANE",
"name_prefix": "Ms.",
"credential": "RN PHN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-04",
"last_updated": "2007-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "320906",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.