Active NPI
Alexis Tepura Pan, RN, BSN
- Psychiatry Physician
- Sacramento, CA
National Provider Identifier
1174398747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 778958
- Practice address
- 8001 Bruceville Rd
Sacramento, CA 95823-2329 - Phone
- (916) 288-0300
- NPI assigned
- Nov 23, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 778958 | CA | Primary |
Addresses
Primary practice location
8001 Bruceville Rd
Sacramento, CA 95823-2329
Mailing address
8001 Bruceville Rd
Sacramento, CA 95823-2329
Phone (916) 288-0300
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
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 778958 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700697600000",
"number": "1174398747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8001 BRUCEVILLE RD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958232329",
"telephone_number": "916-288-0300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8001 BRUCEVILLE RD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958232329",
"telephone_number": "916-288-0300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAN",
"first_name": "ALEXIS",
"middle_name": "TEPURA",
"name_prefix": "Mr.",
"credential": "RN, BSN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-11-23",
"last_updated": "2023-11-23",
"certification_date": "2023-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "778958",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.