Individual provider Active NPI

Maily Vang

  • Family Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1508517277
Registry record updated Mar 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95019557 Issued in CA
Practice address
6169 N Thesta St
Fresno, CA 93710-5266
Phone
(559) 270-8955
NPI assigned
Jan 14, 2022
Last updated
Mar 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95019557 CA Primary

Addresses

Primary practice location

6169 N Thesta St
Fresno, CA 93710-5266

Mailing address

6169 N Thesta St
Fresno, CA 93710-5266
Phone (559) 435-1757

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
95019557CAMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: maily.vang.1@29786.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1642118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648252800000",
    "number": "1508517277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6169 N THESTA ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105266",
            "telephone_number": "559-435-1757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6169 N THESTA ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105266",
            "telephone_number": "559-270-8955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANG",
        "first_name": "MAILY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-14",
        "last_updated": "2022-03-26",
        "certification_date": "2022-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95019557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2022; 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.