Michael Richard Dittrich, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

NP6056 Issued in CA

Practice address

6555 Coyle Ave
Carmichael, CA 95608-0302

Phone

(916) 536-3540

NPI assigned

Nov 17, 2006

Sex

Male

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 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Dignity Health Medical Foundation

  dba Dignity Health Medical Group - North State, a service of Dignity Healt

  • Multi-Specialty Clinic/Center
  • Redding, CA
  • NPI 1912288432
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194899682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2646 STOUGHTON WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958271069",
            "telephone_number": "916-733-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6555 COYLE AVE",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080302",
            "telephone_number": "916-536-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTRICH",
        "first_name": "MICHAEL",
        "middle_name": "RICHARD",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "NP6056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN397509",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5843015",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE",
            "identifier": "90207877",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "000810374542",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT WEST",
            "identifier": "1750289",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2688843",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERPLAN",
            "identifier": "461131",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "N397509",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coral Dickinson, LPCC
• Christian Jeremiah Digap
• Dignity Health (Mercy San Juan Medical Center)
• Dignity Health Medical Foundation (Mercy Imaging Centers, a service of Dignity Health Medical Foundation)
• Tambralane Dill, COTA
• Tu DO, PHARM. D.
• Sydney Grier Dodd, FNP-C
• Donald S Staab Jr, FNP & Jose R Sanchez, MD
• Kelly Ann Frances Donnelly, FNP
• Allison Dooley

• Primary Care Nurse Practitioner in Carmichael, CA
• Providers in Carmichael, CA by specialty
• Primary Care 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.