Individual provider Active NPI

Amanda-Lynn Kubera, STUDENT

  • Registered Nurse
  • Sacramento, CA
National Provider Identifier
1295495778
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
390200000X Issued in CA
Practice address
2570 48TH St
Sacramento, CA 95817-1541
Phone
(916) 734-2145
NPI assigned
Dec 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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 390200000X CA Primary

Addresses

Primary practice location

2570 48TH St
Sacramento, CA 95817-1541

Mailing address

7228 Willowriver CT
Sacramento, CA 95828-4133
Phone (916) 751-8274

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
390200000XCAMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1640217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1295495778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7228 WILLOWRIVER CT",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958284133",
            "telephone_number": "916-751-8274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 48TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171541",
            "telephone_number": "916-734-2145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBERA",
        "first_name": "AMANDA-LYNN",
        "credential": "STUDENT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-23",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "390200000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.

Verify at the official NPI Registry.