Individual provider Active NPI

Sally Sayasa, NP

  • Pain Medicine Physician
  • Fountain Valley, CA
National Provider Identifier
1396497087
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
95019815 Issued in CA
Practice address
9940 Talbert Ave # 101
Fountain Valley, CA 92708-5153
Phone
(949) 872-5699
NPI assigned
Jan 24, 2022
Last updated
Jan 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X 95019815 CA Primary

Addresses

Primary practice location

9940 Talbert Ave # 101
Fountain Valley, CA 92708-5153

Mailing address

8411 Aspenwood Ave
Westminster, CA 92683-6378
Phone (714) 514-0773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220616000548 CA Practitioner - Nurse Practitioner 3375922651 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95019815CAMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
J M Geiss DO Apc CurrentSince Jul 25, 2022 Accepting new patients
Universal Care CurrentSince Oct 9, 2024 Accepting new patients
Central Health Plan of California, Inc. CurrentSince Oct 9, 2024 Accepting new patients
Minghsun Liu, M.D., PC CurrentSince May 31, 2022 Accepting new patients
Access Alliance Medical Group, Inc CurrentSince Jul 14, 2022 Accepting new patients

Locations

105 W Alameda Ave
Ste 210
Burbank, CA 91502
Phone (818) 334-3858

644 W Broadway
Ste 114
Glendale, CA 91204
Phone (818) 334-3858

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

11103 Venice Blvd
Los Angeles, CA 90034
Phone (310) 734-8526

520 Superior Ave
Ste 255
Newport Beach, CA 92663
Phone (949) 720-9266

5 Hutton Centre Dr
Ste 950
Santa Ana, CA 92707
Phone (855) 434-7663

28650 Newhall Ranch Rd
Santa Clarita, CA 91355
Phone (661) 347-0051

Interoperability endpoints

  • Direct secure messaging: ssayasa14636@direct-prd.molinahealthcare.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1642982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1396497087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8411 ASPENWOOD AVE",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926836378",
            "telephone_number": "714-514-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9940 TALBERT AVE # 101",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085153",
            "telephone_number": "949-872-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAYASA",
        "first_name": "SALLY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-24",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "95019815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.