Individual provider Active NPI

Nancy Melgoza, PTA

  • Physical Therapy Assistant
  • Davis, CA
National Provider Identifier
1427406933
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
48019 Issued in CA
Practice address
2008 Imperial Ave
Davis, CA 95616-3161
Phone
(530) 400-9134
NPI assigned
May 25, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 48019 CA Primary

Addresses

Primary practice location

2008 Imperial Ave
Davis, CA 95616-3161

Mailing address

2008 Imperial Ave
Davis, CA 95616-3161
Phone (530) 400-9134

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

State licenses

LicenseStateTypeSpecialty
48019CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1427406933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2008 IMPERIAL AVE",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956163161",
            "telephone_number": "530-400-9134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2008 IMPERIAL AVE",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956163161",
            "telephone_number": "530-400-9134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELGOZA",
        "first_name": "NANCY",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-25",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "48019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; 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.