Individual provider Active NPI

Hazel Mutuc

  • Registered Nurse
  • Vacaville, CA
National Provider Identifier
1336083328
Registry record updated Apr 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95117958 Issued in CA
Practice address
790 Youngsdale Dr
Vacaville, CA 95687-7351
Phone
(707) 319-8424
NPI assigned
Apr 18, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 95117958 CA Primary

Addresses

Primary practice location

790 Youngsdale Dr
Vacaville, CA 95687-7351

Mailing address

790 Youngsdale Dr
Vacaville, CA 95687-7351
Phone (707) 319-8424

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
95117958CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1776470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776470400000",
    "number": "1336083328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 YOUNGSDALE DR",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956877351",
            "telephone_number": "707-319-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 YOUNGSDALE DR",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956877351",
            "telephone_number": "707-319-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTUC",
        "first_name": "HAZEL",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-18",
        "last_updated": "2026-04-18",
        "certification_date": "2026-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95117958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vacaville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2026; 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.