Mavie Clinic Professional Nursing Corporation

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

MAVIE CLINIC PROFESSIONAL NURSING CORPORATION

Doing business as

Mavie Clinic

Practice address

109 Portrait LN
Patterson, CA 95363-8341

Phone

(209) 806-4841

Fax

(209) 290-3320

NPI assigned

Jan 23, 2026

Organization subpart

No

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

Authorized official

Name

Mukhtar Kohistani, FNP-CNPI 1134827272

Title

President

Phone

(209) 806-4841

Specialties & licenses 1

Addresses

Other names 1

• Mavie Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mukhtar Kohistani, FNP-C

  • Family Nurse Practitioner
  • Los Banos, CA
  • NPI 1134827272
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1769126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769385600000",
    "number": "1245189190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 PORTRAIT LN",
            "city": "PATTERSON",
            "state": "CA",
            "postal_code": "953638341",
            "telephone_number": "209-806-4841",
            "fax_number": "209-290-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 PORTRAIT LN",
            "city": "PATTERSON",
            "state": "CA",
            "postal_code": "953638341",
            "telephone_number": "209-806-4841",
            "fax_number": "209-290-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAVIE CLINIC PROFESSIONAL NURSING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-23",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A",
        "authorized_official_last_name": "KOHISTANI",
        "authorized_official_first_name": "MUKHTAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-806-4841",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mavie Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nancy Maciel
• Vinay Kumar Madavan, DDS
• Tracy Manzoni, LEP
• Byanka Marin
• Kaylee Maring
• Nancy Lynne Mayer, M.D.
• Chelsea McCarthy, RN
• Pamela McCullough
• Josephine McKinney
• Medical Transportation of Calif

• Family Nurse Practitioner in Patterson, CA
• Providers in Patterson, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.