Individual provider Active NPI

Sandy West Tysinger, RN

  • Registered Nurse
  • Lafayette, CA
National Provider Identifier
1124697057
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
181101 Issued in NC
Practice address
3595 Mt Diablo Blvd
Lafayette, CA 94549-3851
Phone
(336) 345-5551
NPI assigned
Jun 24, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 181101 NC Primary

Addresses

Primary practice location

3595 Mt Diablo Blvd
Lafayette, CA 94549-3851

Mailing address

3595 Mt Diablo Blvd
Lafayette, CA 94549-3851

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
181101NCMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1124697057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3595 MT DIABLO BLVD",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945493851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3595 MT DIABLO BLVD",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945493851",
            "telephone_number": "336-345-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSINGER",
        "first_name": "SANDY",
        "middle_name": "WEST",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-24",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "181101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.