Individual provider Active NPI

Mandy On, PHARMD

  • Pharmacist
  • Fair Oaks, CA
National Provider Identifier
1437613734
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
73948 Issued in CA
Practice address
5420 Dewey Dr
Fair Oaks, CA 95628-3138
Phone
(916) 864-4803
NPI assigned
Jan 31, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 73948 CA Primary

Addresses

Primary practice location

5420 Dewey Dr
Fair Oaks, CA 95628-3138

Mailing address

5420 Dewey Dr
Fair Oaks, CA 95628-3138

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
73948CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Longs Drug Stores California LLC Past Accepting new patients
Longs Drug Store California LLC Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1437613734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 DEWEY DR",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956283138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 DEWEY DR",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956283138",
            "telephone_number": "916-864-4803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ON",
        "first_name": "MANDY",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-31",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "73948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; 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.