Active NPI
Amy Patchen
- Case Management Registered Nurse
- Perris, CA
National Provider Identifier
1205328309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Registered Nurse
- License
- 774767
- Practice address
- 308 E San Jacinto Ave
Perris, CA 92570-2878 - Phone
- (951) 210-1332
- NPI assigned
- Jun 4, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Case Management Registered Nurse | 163WC0400X | 774767 | CA | Primary |
Addresses
Primary practice location
308 E San Jacinto Ave
Perris, CA 92570-2878
Mailing address
308 E San Jacinto Ave
Perris, CA 92570-2878
Phone (951) 210-1332
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 774767 | CA | MD | Case Management Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528070400000",
"number": "1205328309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 E SAN JACINTO AVE",
"city": "PERRIS",
"state": "CA",
"postal_code": "925702878",
"telephone_number": "951-210-1332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 E SAN JACINTO AVE",
"city": "PERRIS",
"state": "CA",
"postal_code": "925702878",
"telephone_number": "951-210-1332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATCHEN",
"first_name": "AMY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-04",
"last_updated": "2018-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Case Management",
"state": "CA",
"license": "774767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Perris, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.