Individual provider Active NPI

Martha Kabasiita, PHARM.D

  • Pharmacist
  • Fresno, CA
National Provider Identifier
1154802395
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH84560 Issued in CA
Practice address
740 W Alluvial Ave
Suite 101
Fresno, CA 93711
Phone
(800) 797-3543
NPI assigned
Aug 26, 2018
Reactivated
Oct 7, 2021
Last updated
Oct 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 84560 CA
Pharmacist 183500000X RPH84560 CA Primary

Addresses

Primary practice location

740 W Alluvial Ave
Suite 101
Fresno, CA 93711

Mailing address

740 W Alluvial Ave
Suite 101
Fresno, CA 93711
Phone (800) 797-3543

Other names 1

  • Martha Kabasiita Sebina Former name

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
84560CAMDPharmacist
RPH84560CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1535241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1154802395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 W ALLUVIAL AVE",
            "address_2": "SUITE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93711",
            "telephone_number": "800-797-3543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 W ALLUVIAL AVE",
            "address_2": "SUITE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93711",
            "telephone_number": "800-797-3543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABASIITA",
        "first_name": "MARTHA",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-26",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "deactivation_date": "2019-01-17",
        "reactivation_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "84560",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH84560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTHA",
            "last_name": "SEBINA",
            "middle_name": "KABASIITA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.