Individual provider Active NPI

Bethany Certa Sasaki, NP, CNM, IBCLC

  • Women's Health Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1609133602
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
NP95005739 Issued in CA
Practice address
1809 19TH St
Sacramento, CA 95811-6745
Phone
(916) 936-2229
NPI assigned
Apr 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 650391 CA
Advanced Practice Midwife 367A00000X 235738 CA
Women's Health Nurse Practitioner 363LW0102X NP95005739 CA Primary

Addresses

Primary practice location

1809 19TH St
Sacramento, CA 95811-6745

Mailing address

2025 P St
Sacramento, CA 95811-5213
Phone (916) 936-2229

Other practice location 1

2025 P St
Sacramento, CA 95811-5213
Phone (916) 936-2229

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
Credentials
Certified Nurse Midwife, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
650391CAMDLactation Consultant (Registered Nurse)
NP95005739CAMDWomen's Health Nurse Practitioner
235738CAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Midtown Nurse Midwives a Nursing Corporation Lactation Consultant CurrentSince Apr 20, 2025 Accepting new patients
Midtown Nurse Midwives a Nursing Corporation Current Accepting new patients

Locations

2025 P St
Sacramento, CA 95811
Phone (916) 446-4449

4250 H St
Ste 2
Sacramento, CA 95819
Phone (916) 452-5055

1809 19th St
Sacramento, CA 95811
Phone (916) 256-3000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1334275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1609133602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 P ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958115213",
            "telephone_number": "916-936-2229",
            "fax_number": "916-307-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 19TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958116745",
            "telephone_number": "916-936-2229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2025 P St",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958115213",
            "country_code": "US",
            "telephone_number": "916-936-2229",
            "fax_number": "916-307-4626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SASAKI",
        "first_name": "BETHANY",
        "middle_name": "CERTA",
        "credential": "NP, CNM, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-13",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "CA",
            "license": "650391",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "235738",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "NP95005739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.