Individual provider Active NPI

Yvonne Mun, DNP, NP-C

  • Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1306323118
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95022980 Issued in CA
Practice address
1420 River Park Dr Ste 120
Sacramento, CA 95815-4506
Phone
(888) 558-4747
Fax
(916) 404-5556
NPI assigned
Jul 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2490 HI
Nurse Practitioner 363L00000X 95022980 CA Primary

Addresses

Primary practice location

1420 River Park Dr Ste 120
Sacramento, CA 95815-4506

Mailing address

10630 Mountain View Ave Apt B
Redlands, CA 92373-8430
Phone (808) 393-6863

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
I20230213000527 CA Practitioner - Nurse Practitioner 2163776097 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95022980CAMDNurse Practitioner
2490HIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blossom Ridge Medical, Inc. Nurse Practitioner CurrentSince Dec 1, 2022 Accepting new patients

Locations

1420 River Park Dr
Ste 120
Sacramento, CA 95815
Phone (800) 991-6147

2554 Millcreek Dr
Sacramento, CA 95833
Phone (800) 991-6147

Interoperability endpoints

  • Direct secure messaging: yvonne.yokono.p1@direct.wcchc.nextgenshare.com

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": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1306323118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10630 MOUNTAIN VIEW AVE APT B",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738430",
            "telephone_number": "808-393-6863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 RIVER PARK DR STE 120",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154506",
            "telephone_number": "888-558-4747",
            "fax_number": "916-404-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUN",
        "first_name": "YVONNE",
        "name_prefix": "Dr.",
        "credential": "DNP, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-24",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "HI",
            "license": "2490",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95022980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.