Individual provider Active NPI

Didi Kabuya

  • Psychiatric/Mental Health Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1275099780
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95031194 Issued in CA
Practice address
2108 N St # 7087
Sacramento, CA 95816
Phone
(213) 389-2649
NPI assigned
Feb 20, 2019
Last updated
Dec 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95031194 CA Primary
Registered Nurse 163W00000X 770417 CA

Addresses

Primary practice location

2108 N St # 7087
Sacramento, CA 95816

Mailing address

400 N Pepper Ave
Colton, CA 92324-1801

Other practice location 1

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-3145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250422002496 NY Practitioner - Nurse Practitioner 4880119809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2108 N St
Suite 7087
Sacramento, CA 95816-5712

PO Box
Suite 451249
Los Angeles, CA 90045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
770417CAMDRegistered Nurse
95031194CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sehwan Medical Care PLLC CurrentSince Feb 16, 2025 Accepting new patients

Locations

831 Bedford Ave
Brooklyn, NY 11205

45 Ludlow St
Ste 402
Yonkers, NY 10705
Phone (914) 457-3325

Organizations & group practices 1

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": "1550620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1275099780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 N ST # 7087",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95816",
            "telephone_number": "213-389-2649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N Pepper Ave",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923241801",
            "country_code": "US",
            "telephone_number": "909-580-3145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KABUYA",
        "first_name": "DIDI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-20",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95031194",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "770417",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.