Individual provider Active NPI

Adriane Marie Roxas Nguyen, D.O.

  • Family Medicine Physician
  • Vallejo, CA
National Provider Identifier
1235324336
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A9764 Issued in CA
Practice address
975 Sereno Drive
Vallejo, CA 94589
Phone
(707) 651-1025
NPI assigned
Sep 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A9764 CA Primary

Addresses

Primary practice location

975 Sereno Drive
Vallejo, CA 94589

Mailing address

975 Sereno Drive
Vallejo, CA 94589
Phone (707) 651-1025

Other names 1

  • Adriane Marie Vargas Roxas Former name

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200414001590 CA Order and Referring Only - Family PracticePractitioner - Family Practice 6901965318

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A9764CAMDFamily Medicine Physician
9764CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359936000000",
    "number": "1235324336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 SERENO DRIVE",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "94589",
            "telephone_number": "707-651-1025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 SERENO DRIVE",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "94589",
            "telephone_number": "707-651-1025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ADRIANE MARIE",
        "middle_name": "ROXAS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2013-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A9764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADRIANE MARIE",
            "last_name": "ROXAS",
            "middle_name": "VARGAS",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.