Anna Marie Maagdenberg, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

G25706 Issued in CA

Practice address

455 Grand Ave
South San Francisco, CA 94080-3635

Phone

(650) 636-1286

Fax

(650) 588-4164

NPI assigned

Sep 21, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1253491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253491200000",
    "number": "1386978542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 UNION ST",
            "address_2": "SUITE 300",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941234114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 GRAND AVE",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940803635",
            "telephone_number": "650-636-1286",
            "fax_number": "650-588-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAAGDENBERG",
        "first_name": "ANNA MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-21",
        "last_updated": "2009-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "G25706",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "G25706",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PIN RENDERING UNDER",
            "identifier": "ZZZ96273Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA RN/LP LISCENCE",
            "identifier": "G25706",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas D. Lupton, MD
• Lawrence B. Lusk, MD
• Jamison Joel Ly, PT
• M & M Medical Supplies, Inc.
• Kenneth Ma, PHAMACIST
• Michael C. Macavoy, MD
• Madison Macay
• Rafael Macias
• Kristyna Polata Maclaurin
• Debbie Madden

• Nurse Practitioner in South San Francisco, CA
• Providers in South San Francisco, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2009; 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.