Individual provider Active NPI

Andrea Santos, RN

  • Registered Nurse
  • Marysville, CA
National Provider Identifier
1265830871
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95044114 Issued in CA
Practice address
5730 Packard Ave Ste 500
Marysville, CA 95901-7119
Phone
(530) 749-3242
Fax
(530) 749-3248
NPI assigned
Dec 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95044114 CA Primary

Addresses

Primary practice location

5730 Packard Ave Ste 500
Marysville, CA 95901-7119

Mailing address

1114 Yuba St RM 144
Marysville, CA 95901-4838
Phone (530) 749-3242

Other practice location 1

3451 E 12th St
Oakland, CA 94601-3463
Phone (650) 454-5133

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
I20200420001152 CA Practitioner - Nurse Practitioner 9638445844 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children Current Accepting new patients
Shriners Hospitals for Children CurrentSince Aug 1, 2022 Accepting new patients
Shriners Hospitals for Children CurrentSince Aug 1, 2022 Accepting new patients
Shriners Hospitals for Children Past Accepting new patients

Locations

2425 Stockton Blvd
Sacramento, CA 95817
Phone (916) 453-2000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1418342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1265830871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 YUBA ST RM 144",
            "city": "MARYSVILLE",
            "state": "CA",
            "postal_code": "959014838",
            "telephone_number": "530-749-3242",
            "fax_number": "530-749-3248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5730 PACKARD AVE STE 500",
            "city": "MARYSVILLE",
            "state": "CA",
            "postal_code": "959017119",
            "telephone_number": "530-749-3242",
            "fax_number": "530-749-3248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3451 E 12th St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946013463",
            "country_code": "US",
            "telephone_number": "650-454-5133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "ANDREA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-12",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95044114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, CA

Sources for this page

Verify at the official NPI Registry.