Izola Mary Chaney, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

22885 Issued in CA

Practice address

21830 Cactus Ave Ste 302
Riverside, CA 92518-3010

Phone

(951) 653-5291

NPI assigned

Jul 8, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Izola Mary Phillips Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: ichaney784532@direct.llu.edu

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1154737492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21830 CACTUS AVE STE 302",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925183010",
            "telephone_number": "951-653-5291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21830 CACTUS AVE STE 302",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925183010",
            "telephone_number": "951-653-5291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANEY",
        "first_name": "IZOLA",
        "middle_name": "MARY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-08",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "22885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IZOLA",
            "last_name": "PHILLIPS",
            "middle_name": "MARY",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Riverside, CA
• Providers in Riverside, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.