Sam Ustrzynski, DNP, FNP-C, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

20405 Issued in CA

Practice address

513 Parnassus Ave # S458
San Francisco, CA 94143-2205

Phone

(155) 148-7964

NPI assigned

Jun 16, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 7

Addresses

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.

• Regents of the University of California

  • Pharmacy
  • San Diego, CA
  • NPI 1598786576
  NPD (past)
• Regents of the University of California Ucsd Head and Neck Surgery

  • Otolaryngology Physician
  • San Diego, CA
  • NPI 1679509962
  NPD (past)

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725148800000",
    "number": "1194952218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 PARNASSUS AVE # S458",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432205",
            "telephone_number": "155-148-7964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 PARNASSUS AVE # S458",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432205",
            "telephone_number": "155-148-7964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3801 Miranda Ave",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943041207",
            "country_code": "US",
            "telephone_number": "650-493-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "USTRZYNSKI",
        "first_name": "SAM",
        "credential": "DNP, FNP-C, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-16",
        "last_updated": "2024-09-01",
        "certification_date": "2024-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "CA",
            "license": "715183",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "715183",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "20405",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "20405",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "20405",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "20405",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "20405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Usha Rajagopal MD Inc
• Maya Yin Lai Ushijima, MD
• Kudret Iman Usmani, MD
• Chris John Usselman
• Ust Health Inc
• Lauren Mackenzie Gearhart Utchen
• Nina M Utigaard, MFT, REAT
• Joni Lynn Utley, PSYD
• Steven Andrew Utstein, CRNA
• Masayuki N Utsumi, D.C.

• Psychiatric/Mental Health Nurse Practitioner in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2024; 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.