Individual provider Active NPI

Han Ngo

  • Registered Nurse
  • Sacramento, CA
National Provider Identifier
1104537331
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95396494 Issued in CA
Practice address
2150 Stockton Blvd
Sacramento, CA 95817-1337
Phone
(916) 346-8825
NPI assigned
Dec 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95396494 CA Primary
Licensed Vocational Nurse 164X00000X 705355 CA

Addresses

Primary practice location

2150 Stockton Blvd
Sacramento, CA 95817-1337

Mailing address

2150 Stockton Blvd
Sacramento, CA 95817-1337
Phone (916) 346-8825

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

LicenseStateTypeSpecialty
95396494CAMDRegistered Nurse
705355CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1670457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1104537331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171337",
            "telephone_number": "916-346-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171337",
            "telephone_number": "916-346-8825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO",
        "first_name": "HAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-08",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95396494",
            "primary": true
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "705355",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.