Individual provider Active NPI

Divya Nalli, PMHNP-BC, FNP-C, MSN

  • Psychiatric/Mental Health Nurse Practitioner
  • Newman, CA
National Provider Identifier
1235866773
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95022030 Issued in CA
Practice address
1349 Main St
Newman, CA 95360-1326
Phone
(209) 862-3604
NPI assigned
Aug 4, 2022
Last updated
Aug 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95022030 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95022030 CA Primary

Addresses

Primary practice location

1349 Main St
Newman, CA 95360-1326

Mailing address

1001 Blue Range Way
Roseville, CA 95747-4497
Phone (916) 776-3584

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220919001481 CA Practitioner - Nurse Practitioner 6800271412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beautiful Minds Medical, Inc.Group PAC ID 3072783364, 14 clinicians
Rural Health Network IncGroup PAC ID 1759740350, 5 clinicians
Randhawa Medical Group IncGroup PAC ID 6406920412, 5 clinicians

Practice addresses (Care Compare)

13300 New Airport Rd
Suite 100
Auburn, CA 95602-7407
Phone (530) 889-8780

1349 Main St
Newman, CA 95360-1326
Phone (209) 862-3604

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95022030CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beautiful Minds Medical, Inc. CurrentSince Dec 16, 2025 Accepting new patients

Locations

13300 New Airport Rd
Ste 100
Auburn, CA 95602
Phone (530) 888-4557

381A Nevada St
Auburn, CA 95603
Phone (530) 368-0571

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCJEBA

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1235866773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BLUE RANGE WAY",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957474497",
            "telephone_number": "916-776-3584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1349 MAIN ST",
            "city": "NEWMAN",
            "state": "CA",
            "postal_code": "953601326",
            "telephone_number": "209-862-3604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALLI",
        "first_name": "DIVYA",
        "credential": "PMHNP-BC, FNP-C, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-04",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95022030",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95022030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newman, CA

Sources for this page

Verify at the official NPI Registry.