Individual provider Active NPI

Mariana Anastasia Mojica, RN

  • Mental Illness Intermediate Care Facility
  • Merced, CA
National Provider Identifier
1104224732
Registry record updated Dec 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Intermediate Care FacilityTaxonomy code 310500000X
License
95037524 Issued in CA
Practice address
300 E 15TH St
Merced, CA 95341-6217
Phone
(209) 381-6879
NPI assigned
Dec 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Intermediate Care Facility 310500000X 95037524 CA Primary

Addresses

Primary practice location

300 E 15TH St
Merced, CA 95341-6217

Mailing address

3545 Sarasota Ave
Merced, CA 95348-9399
Phone (209) 233-4501

Other identifiers 3

IdentifierTypeStateIssuer
95037524OtherCARN LICENSE
CA02761OtherCABLS
CA15264OtherCAACLS

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
95037524CAMDMental Illness Intermediate Care Facility

NPI Registry JSON

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

{
    "created_epoch": "1418515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418515200000",
    "number": "1104224732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 SARASOTA AVE",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953489399",
            "telephone_number": "209-233-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E 15TH ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953416217",
            "telephone_number": "209-381-6879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOJICA",
        "first_name": "MARIANA",
        "middle_name": "ANASTASIA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-14",
        "last_updated": "2014-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": "CA",
            "license": "95037524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "95037524",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLS",
            "identifier": "CA02761",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACLS",
            "identifier": "CA15264",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2014; 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.