Individual provider Active NPI

Ann Marie Mullen, MS

  • Audiologist
  • Sacramento, CA
National Provider Identifier
1104910652
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AU999 Issued in CA
Practice address
5342 Dudley Blvd.
Sacramento, CA 95652
Phone
(916) 561-7400
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AU999 CA Primary

Addresses

Primary practice location

5342 Dudley Blvd.
Sacramento, CA 95652

Mailing address

6125 Rockhurst Way
Granite Bay, CA 95746
Phone (916) 791-5101

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
Master of Science

State licenses

LicenseStateTypeSpecialty
AU999CAMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104910652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6125 ROCKHURST WAY",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "95746",
            "telephone_number": "916-791-5101",
            "fax_number": "916-791-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5342 DUDLEY BLVD.",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95652",
            "telephone_number": "916-561-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "ANN MARIE",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "AU999",
            "primary": true
        }
    ],
    "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 Jul 8, 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.

Verify at the official NPI Registry.