David Tkach, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

95212426 Issued in CA

Practice address

10850 Gold Center Dr Ste 325
Rancho Cordova, CA 95670-6177

Phone

(530) 304-8780

NPI assigned

Oct 14, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1104424811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10850 GOLD CENTER DR STE 325",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956706177",
            "telephone_number": "530-304-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10850 GOLD CENTER DR STE 325",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956706177",
            "telephone_number": "530-304-8780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TKACH",
        "first_name": "DAVID",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-14",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95212426",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95212426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Rancho Cordova, CA
• Providers in Rancho Cordova, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.

Verify at the official NPI Registry.