Constance Mitchell, NURSE PRACTITIONER

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

95009958 Issued in CA

Practice address

2425 Stockton Blvd
Sacramento, CA 95817-2215

Phone

(707) 672-6536

Fax

(916) 453-5038

NPI assigned

Jul 24, 2012

Last updated

Oct 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shriners Hospitals for Children

  • Pediatric Orthopaedic Surgery Physician
  • Sacramento, CA
  • NPI 1679915565
  Medicare reassignment NPD
• Shriners Hospitals for Children

  • Anesthesiology Physician
  • Sacramento, CA
  • NPI 1114415361
  NPD
• Shriners Hospitals for Children

  dba Shriners Children's Hawaii

  • Clinic/Center
  • Aiea, HI
  • NPI 1568299857
  NPD
• Redwood Pediatric Medical Group

  • Specialist
  • Fortuna, CA
  • NPI 1164574083
  NPD (past)

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1205181526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172215",
            "telephone_number": "707-672-6536",
            "fax_number": "916-453-5038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172215",
            "telephone_number": "707-672-6536",
            "fax_number": "916-453-5038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Redwood Pediatrics",
            "address_2": "3305 Renner dr",
            "address_purpose": "LOCATION",
            "city": "Fortuna",
            "state": "CA",
            "postal_code": "95540",
            "country_code": "US",
            "telephone_number": "707-725-9355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "MCKINLEYVILLE MIDDLE SCHOOL CLINIC",
            "address_2": "2285 Central Avenue",
            "address_purpose": "LOCATION",
            "city": "McKinleyville",
            "state": "CA",
            "postal_code": "95519",
            "country_code": "US",
            "telephone_number": "707-839-1508",
            "fax_number": "707-839-2548",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "529 I St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955011116",
            "country_code": "US",
            "telephone_number": "707-268-2015",
            "fax_number": "707-445-6091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "CONSTANCE",
        "name_prefix": "Miss",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-24",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95009958",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN781915",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Anne-Marie Mitchell, LMFT
• Carmen Nicole Mitchell
• Cerresa Renee Mitchell
• Christopher C Mitchell, CADC-IICA
• Connie Mitchell, MD, MPH
• Damon Mitchell
• David George Mitchell, PHARM.D.
• Deana Jo Mitchell
• Devery E Mitchell, MD
• Dianne Ilene Mitchell, DPM

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.