Individual provider Active NPI

Edidia F Demian

  • Assisted Living Facility
  • Citrus Heights, CA
National Provider Identifier
1124492574
Registry record updated Nov 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
347002299 Issued in CA
Practice address
8440 Edgecliff CT
Citrus Heights, CA 95610-0842
Phone
(916) 753-6430
Fax
(916) 560-3801
NPI assigned
Nov 23, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 347002299 CA Primary

Addresses

Primary practice location

8440 Edgecliff CT
Citrus Heights, CA 95610-0842

Mailing address

8440 Edgecliff CT
Citrus Heights, CA 95610-0842
Phone (916) 753-6430

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
347002299CAMDAssisted Living Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Care Alot Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1448236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1124492574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8440 EDGECLIFF CT",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956100842",
            "telephone_number": "916-753-6430",
            "fax_number": "916-560-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8440 EDGECLIFF CT",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956100842",
            "telephone_number": "916-753-6430",
            "fax_number": "916-560-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMIAN",
        "first_name": "EDIDIA",
        "middle_name": "F",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-23",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "347002299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Citrus Heights, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.