Active NPI
Nicholas Daniel Musso, D.O.
- Psychiatry Physician
- Stockton, CA
National Provider Identifier
1255677670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 20A18757
- Practice address
- 7707 Austin Rd
Stockton, CA 95215 - Phone
- (209) 467-2500
- NPI assigned
- Dec 13, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 20A18757 | CA | Primary |
Addresses
Primary practice location
7707 Austin Rd
Stockton, CA 95215
Mailing address
949 Northridge Dr
Bountiful, UT 84010-1717
Phone (801) 712-6125
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A18757 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623196800000",
"number": "1255677670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "949 NORTHRIDGE DR",
"city": "BOUNTIFUL",
"state": "UT",
"postal_code": "840101717",
"telephone_number": "801-712-6125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7707 AUSTIN RD",
"city": "STOCKTON",
"state": "CA",
"postal_code": "95215",
"telephone_number": "209-467-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUSSO",
"first_name": "NICHOLAS",
"middle_name": "DANIEL",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-12-13",
"last_updated": "2021-06-09",
"certification_date": "2021-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "20A18757",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.