Individual provider Active NPI

Marisella Fustamante Carranza

  • Ambulatory Women's Health Care Registered Nurse
  • San Francisco, CA
National Provider Identifier
1336090471
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Women's Health Care Registered NurseTaxonomy code 163WW0101X
License
773064 Issued in CA
Practice address
1001 Potrero Ave
San Francisco, CA 94110-3518
Phone
(415) 823-0176
NPI assigned
Feb 5, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Women's Health Care Registered Nurse 163WW0101X 773064 CA Primary

Addresses

Primary practice location

1001 Potrero Ave
San Francisco, CA 94110-3518

Mailing address

1 Harrington Rd
Moraga, CA 94556-2814
Phone (415) 823-3005

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
773064CAMDAmbulatory Women's Health Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1770249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1336090471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HARRINGTON RD",
            "city": "MORAGA",
            "state": "CA",
            "postal_code": "945562814",
            "telephone_number": "415-823-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "415-823-0176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRANZA",
        "first_name": "MARISELLA",
        "middle_name": "FUSTAMANTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-05",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "CA",
            "license": "773064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.