Mia Raab, BSN, RN, PHN

Primary specialty

School Registered NurseTaxonomy code 163WS0200X

License

723456 Issued in CA

Practice address

3501 Spruce Ave
South Lake Tahoe, CA 96150-2318

Phone

(530) 543-2337

Fax

(530) 543-2342

NPI assigned

Dec 3, 2024

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1733184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1548086739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 SPRUCE AVE",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961502318",
            "telephone_number": "530-543-2337",
            "fax_number": "530-543-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 SPRUCE AVE",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961502318",
            "telephone_number": "530-543-2337",
            "fax_number": "530-543-2342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1095 E San Bernardino Ave",
            "address_purpose": "LOCATION",
            "city": "South Lake Tahoe",
            "state": "CA",
            "postal_code": "961505235",
            "country_code": "US",
            "telephone_number": "530-545-2371 x1401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAAB",
        "first_name": "MIA",
        "name_prefix": "Mrs.",
        "credential": "BSN, RN, PHN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-03",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "CA",
            "license": "723456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chloe H Puglisi
• Marcelina Nate Pulido
• Joanna Malgorzata Puszka, PHARM D
• Nicholas Quazzo
• Quick Care Tahoe Providers Medical Corporation
• Jessica Woods Rafferty, PTA
• Raleys
• Marianna Randolph, LCSW
• Robyn R Rasmussen, MS
• Debra Annette Rau-Jacques, PT

• School Registered Nurse in South Lake Tahoe, CA
• Providers in South Lake Tahoe, CA by specialty
• School Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.