Individual provider Active NPI

Pamela Sue Porter, APRN, MSN, FNP,BC

  • Family Nurse Practitioner
  • Elk Grove, CA
National Provider Identifier
1366481178
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN 445209 FNP 6259 Issued in CA
Practice address
9281 Office Park Cir
Suite 120
Elk Grove, CA 95758-8068
Phone
(916) 691-5988
Fax
(916) 691-6717
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN 445209 FNP 6259 CA Primary

Addresses

Primary practice location

9281 Office Park Cir
Suite 120
Elk Grove, CA 95758-8068

Mailing address

3322 Laguna Ave
Davis, CA 95616-4918
Phone (916) 923-2107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
6259CAMDOptician
RN 445209 FNP 6259CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1366481178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3322 LAGUNA AVE",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956164918",
            "telephone_number": "916-923-2107",
            "fax_number": "916-648-9131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9281 OFFICE PARK CIR",
            "address_2": "SUITE 120",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957588068",
            "telephone_number": "916-691-5988",
            "fax_number": "916-691-6717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "PAMELA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "APRN, MSN, FNP,BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "RN 445209 FNP 6259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

Verify at the official NPI Registry.