Individual provider Active NPI

Mary Ann Sayon

  • Gerontology Nurse Practitioner
  • Yucca, Valley, CA
National Provider Identifier
1164028080
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
95016062 Issued in CA
Practice address
57402 Twentynine Palms Highway #1
Yucca, Valley, CA 92284
Phone
(310) 384-0371
NPI assigned
Dec 7, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 95016062 CA Primary

Addresses

Primary practice location

57402 Twentynine Palms Highway #1
Yucca, Valley, CA 92284

Mailing address

73373 Country Club Dr Apt 3001
Palm Desert, CA 92260-8642
Phone (310) 384-0371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210401001089 CA Practitioner - Nurse Practitioner 3375950694

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
David Perz, DO Inc. PastSince Apr 28, 2019 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": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1164028080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73373 COUNTRY CLUB DR APT 3001",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922608642",
            "telephone_number": "310-384-0371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57402 TWENTYNINE PALMS HIGHWAY #1",
            "city": "YUCCA, VALLEY",
            "state": "CA",
            "postal_code": "92284",
            "telephone_number": "310-384-0371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAYON",
        "first_name": "MARY ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-07",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95016062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucca, Valley, CA

Sources for this page

Verify at the official NPI Registry.