Yetzenia Moura, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95021484 Issued in CA

Practice address

3234 Marysville Blvd
Sacramento, CA 95815-1411

Phone

(916) 454-2345

NPI assigned

Jul 6, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Elica Health Centers

  • Federally Qualified Health Center (FQHC)
  • West Sacramento, CA
  • NPI 1548425853

  CA

  Medicare reassignment NPD
• Elica Health Centers

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1265059182
  NPD
• Elica Health Centers

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1760293351
  NPD

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1508599648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 HOWE AVE STE 440",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958251098",
            "telephone_number": "916-569-8484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3234 MARYSVILLE BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958151411",
            "telephone_number": "916-454-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOURA",
        "first_name": "YETZENIA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-06",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95021484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mountain Valley Child and Family Services, Inc.
• Mountain Valley Child and Family Services, Inc.
• Mountain West Non-Emergency Medical Transportation, LLC
• Mountainside Allergy and Immunology Group
• Allan Douglas Mounts, PH.D.
• Hossein Mousavi, MD
• Kareem Moussa, MD
• Briana Christine Mouzon
• Teslene Mechel Mouzon
• Natalie Movsessian, NP

• All providers in Sacramento, CA
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.