Active NPI
Sandra S Peck, FNP
- Primary Care Nurse Practitioner
- Oakhurst, CA
National Provider Identifier
1346229853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- GU325Y
- Practice address
- 48677 Victoria LN
Oakhurst, CA 93644-9216 - Phone
- (559) 683-6331
- NPI assigned
- Jan 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | GU325Y | CA | Primary |
Addresses
Primary practice location
48677 Victoria LN
Oakhurst, CA 93644-9216
Mailing address
PO Box 28900
Fresno, CA 93729
Phone (559) 228-4205
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GU325Y | Other | CA | MEDICARE ID-TYPE UNSPECIFIED |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9701 | CA | MD | Speech-Language Assistant |
| GU325Y | CA | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marvin P Matlock M D Inc | Past | Accepting new patients | |
| Primary Care Consultants, Inc. a Medical Group | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Fresno, CA
- NPI 1346486396
-
- Family Medicine Physician
- Clovis, CA
- NPI 1659303832
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369267200000",
"number": "1346229853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 28900",
"city": "FRESNO",
"state": "CA",
"postal_code": "93729",
"telephone_number": "559-228-4205",
"fax_number": "559-224-3920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "48677 VICTORIA LN",
"city": "OAKHURST",
"state": "CA",
"postal_code": "936449216",
"telephone_number": "559-683-6331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECK",
"first_name": "SANDRA",
"middle_name": "S",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-12",
"last_updated": "2013-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "CA",
"license": "GU325Y",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID-TYPE UNSPECIFIED",
"identifier": "GU325Y",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oakhurst, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.