Marichu Nisperos, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA17851 Issued in CA

Practice address

330 Northgate Dr
Manteca, CA 95336-3139

Phone

(209) 239-1996

Fax

(209) 239-2876

NPI assigned

Jun 29, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: marichu.nisperos.p1@direct.cmcentersinc.nextgenshare.com
• FHIR API: https://fhir-myrecord.cerner.com/r4/73bc01f5-9bdd-4e4b-ba52-efb00b8cec28/

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1285998690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 RAINWELL DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951331934",
            "telephone_number": "408-482-9788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 NORTHGATE DR",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953363139",
            "telephone_number": "209-239-1996",
            "fax_number": "209-239-2876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISPEROS",
        "first_name": "MARICHU",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-29",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vuong Q Nguyen, PHARM.D
• Nicole Pham DPM Professional Corporation
• Erwin Osia Nillo, PT
• Sarrah Niru
• Carmelita Casison Nisperos, M.D.
• Jasmine Noches
• Selia Noddin, BCBA
• Noel C David MD Inc
• Ricky Nolasco
• Norcal Urgent Care, Inc

• Physician Assistant in Manteca, CA
• Providers in Manteca, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; 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.