Individual provider Active NPI

Sandra Ann Kreizenbeck, NP

  • Family Nurse Practitioner
  • Pleasanton, CA
National Provider Identifier
1538409669
Registry record updated Feb 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22456 Issued in CA
Practice address
4463 Stoneridge Dr Ste a
Pleasanton, CA 94588-8402
Phone
(925) 846-6300
Fax
(925) 846-6323
NPI assigned
Feb 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2013

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 22456 CA Primary

Addresses

Primary practice location

4463 Stoneridge Dr Ste a
Pleasanton, CA 94588-8402

Mailing address

4463 Stoneridge Dr Ste a
Pleasanton, CA 94588-8402
Phone (925) 846-6300

Other names 1

  • Mrs. Sandra Ann Kreizenbeck Professional name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20140910000383 CA Order and Referring Only - Nurse Practitioner 4082833819

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
22456CAMDSpeech-Language Pathologist

Interoperability endpoints

  • Direct secure messaging: sandra.kreizenbeck@3141477138436.direct.elationemr.com

NPI Registry JSON

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

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361923200000",
    "number": "1538409669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4463 STONERIDGE DR STE A",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888402",
            "telephone_number": "925-846-6300",
            "fax_number": "925-846-6323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4463 STONERIDGE DR STE A",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888402",
            "telephone_number": "925-846-6300",
            "fax_number": "925-846-6323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREIZENBECK",
        "first_name": "SANDRA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-27",
        "last_updated": "2013-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "22456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "KREIZENBECK",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.