Individual provider Active NPI

Mary Kaneakalau, BSN, RN, PHN, CSN

  • School Registered Nurse
  • Bakersfield, CA
National Provider Identifier
1356815831
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
250408 Issued in CA
Practice address
1530 E 19TH St
Bakersfield, CA 93305-5406
Phone
(661) 319-8223
NPI assigned
Jan 17, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 250408 CA Primary

Addresses

Primary practice location

1530 E 19TH St
Bakersfield, CA 93305-5406

Mailing address

3812 Barbara Ave
Bakersfield, CA 93309-6042
Phone (661) 319-8223

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
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
250408CAMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1356815831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3812 BARBARA AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933096042",
            "telephone_number": "661-319-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 E 19TH ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933055406",
            "telephone_number": "661-319-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANEAKALAU",
        "first_name": "MARY",
        "credential": "BSN, RN, PHN, CSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-17",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "CA",
            "license": "250408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; 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.