Kathleen Ann McCallum, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

336259 Issued in CA

Practice address

1200 Suncast LN Ste 5
El Dorado Hills, CA 95762-9664

Phone

(916) 939-3889

Fax

(916) 939-3816

NPI assigned

Sep 5, 2023

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 names 1

• Missey McCallum Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1497531545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3341 CAMBRIDGE RD",
            "city": "CAMERON PARK",
            "state": "CA",
            "postal_code": "956829121",
            "telephone_number": "530-409-3652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SUNCAST LN STE 5",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957629664",
            "telephone_number": "916-939-3889",
            "fax_number": "916-939-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALLUM",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-05",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "RN86999",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "336259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MISSEY",
            "last_name": "MCCALLUM",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ryan Maxwell Maves, DPT
• Jamie Maynard
• Maria Mazariegos
• James McAlister, RPH
• Julie McBride
• Jennifer McCarthy
• Teresa Eleanor McCormick
• Mackenzie Claire McCoy, PT, DPT
• Rylie McCoy
• Jonah McGarvey-Tanenbaum

• Registered Nurse in El Dorado Hills, CA
• Providers in El Dorado Hills, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.