Individual provider Active NPI

Jacinda Ann Maurer, RN

  • Registered Nurse
  • Capitola, CA
National Provider Identifier
1104103399
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95021915 Issued in CA
Practice address
4725 Grace Street
Apt. 1
Capitola, CA 95010
Phone
(720) 220-2124
NPI assigned
Nov 16, 2011
Last updated
Mar 18, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 195879 CO
Registered Nurse 163W00000X 95021915 CA Primary
Hemodialysis Registered Nurse 163WH0500X 95021915 CA

Addresses

Primary practice location

4725 Grace Street
Apt. 1
Capitola, CA 95010

Mailing address

4725 Grace Street
Apt. 1
Capitola, CA 95010
Phone (303) 275-7582

Other names 1

  • Miss Jacinda Ann Croissant Former name

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

LicenseStateTypeSpecialty
95021915CAMDRegistered Nurse
195879COMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1104103399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4725 GRACE STREET",
            "address_2": "APT. 1",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "95010",
            "telephone_number": "303-275-7582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 GRACE STREET",
            "address_2": "APT. 1",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "95010",
            "telephone_number": "720-220-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURER",
        "first_name": "JACINDA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-16",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CO",
            "license": "195879",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95021915",
            "primary": true
        },
        {
            "code": "163WH0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hemodialysis",
            "state": "CA",
            "license": "95021915",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACINDA",
            "last_name": "CROISSANT",
            "middle_name": "ANN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Capitola, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; 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.