Nancy A Derthick, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

149460 Issued in CA

Practice address

2432 Loma Vista Dr
Sacramento, CA 95825-0310

Phone

(916) 489-0900

Fax

(916) 489-1657

NPI assigned

Jun 11, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164626644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2432 LOMA VISTA DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958250310",
            "telephone_number": "916-489-0900",
            "fax_number": "916-489-1657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2432 LOMA VISTA DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958250310",
            "telephone_number": "916-489-0900",
            "fax_number": "916-489-1657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERTHICK",
        "first_name": "NANCY",
        "middle_name": "A",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "149460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "149460",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER FURN.",
            "identifier": "1995",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Lauren Derosa, LMSW
• Danielle Derosa, PA-C
• Kelli Linn Derrah
• Joanne Derrick
• Emma Derstine
• Tierra Tenay Derusha
• Pooja Patricia Desa, M.D.
• Penelope E Desafey, CRNA
• Amisha Desai, M.D.
• Angel N Desai, M.D., MPH

• Nurse Practitioner in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.