Active NPI
Theresa Capitonoff
- Neuroscience Clinical Nurse Specialist
- Vacaville, CA
National Provider Identifier
1497536007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neuroscience Clinical Nurse Specialist
- License
- 184055
- Practice address
- 549 Main St
Vacaville, CA 95688-3911 - Phone
- (530) 601-9696
- NPI assigned
- Oct 10, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Neuroscience Clinical Nurse Specialist | 364SN0800X | 184055 | CA | Primary |
Addresses
Primary practice location
549 Main St
Vacaville, CA 95688-3911
Mailing address
549 Main St
Vacaville, CA 95688-3911
Phone (530) 601-9696
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
| License | State | Type | Specialty |
|---|---|---|---|
| 184055 | CA | MD | Neuroscience Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696896000000",
"number": "1497536007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "549 MAIN ST",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "956883911",
"telephone_number": "530-601-9696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "549 MAIN ST",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "956883911",
"telephone_number": "530-601-9696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAPITONOFF",
"first_name": "THERESA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-10-10",
"last_updated": "2023-10-10",
"certification_date": "2023-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "364SN0800X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Neuroscience",
"state": "CA",
"license": "184055",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vacaville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.