Active NPI
Angeline Poulos, N.P.
- Nurse Practitioner
- Sacramento, CA
National Provider Identifier
1437315686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 18161
- Practice address
- 7601 Hospital Dr Ste 204
Sacramento, CA 95823-5408 - Phone
- (916) 681-6510
- Fax
- (916) 681-6544
- NPI assigned
- Aug 6, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 18161 | CA | Primary |
Addresses
Primary practice location
7601 Hospital Dr Ste 204
Sacramento, CA 95823-5408
Mailing address
5373 Noyack Way
Sacramento, CA 95835
Phone (916) 681-6510
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18161 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217980800000",
"number": "1437315686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5373 NOYACK WAY",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95835",
"telephone_number": "916-681-6510",
"fax_number": "916-681-6544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7601 HOSPITAL DR STE 204",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958235408",
"telephone_number": "916-681-6510",
"fax_number": "916-681-6544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POULOS",
"first_name": "ANGELINE",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-06",
"last_updated": "2008-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "18161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.