Connie Alcamo

Primary specialty

Pediatric Registered NurseTaxonomy code 163WP0200X

License

439173 Issued in CA

Practice address

2940 Lake Tahoe Blvd
South Lake Tahoe, CA 96150-7800

Phone

(305) 416-4045

Fax

(530) 541-4624

NPI assigned

Dec 3, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Connie Marie Agostini Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1733184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1235955436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 LAKE TAHOE BLVD",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507800",
            "telephone_number": "305-416-4045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 LAKE TAHOE BLVD",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507800",
            "telephone_number": "305-416-4045",
            "fax_number": "530-541-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALCAMO",
        "first_name": "CONNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-03",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "CA",
            "license": "439173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "AGOSTINI",
            "middle_name": "MARIE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Adams Wilkins
• Dalia Aguilar, PHARMD.
• Fabiola E Aguirre
• Margarita Paloma Aguirre
• Catherine Aisner, PH.D.
• All My Radiology
• Lisa L Allen, BS
• Marc Alper
• Tessa Dahlen Amos, NP-C
• Bradley W Anderson, MD

• Pediatric Registered Nurse in South Lake Tahoe, CA
• Providers in South Lake Tahoe, CA by specialty
• Pediatric Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.