Active NPI
Paula J Pettit, LVN
- Home Health Aide
- Roseville, CA
National Provider Identifier
1609170265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 244891
- Practice address
- 1513 Eriswell Dr
Roseville, CA 95747-4522 - Phone
- (916) 749-9858
- Fax
- (916) 772-0500
- NPI assigned
- Dec 22, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 244891 | CA | Primary |
Addresses
Primary practice location
1513 Eriswell Dr
Roseville, CA 95747-4522
Mailing address
1513 Eriswell Dr
Roseville, CA 95747-4522
Phone (916) 749-9858
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
| License | State | Type | Specialty |
|---|---|---|---|
| 244891 | CA | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292976000000",
"number": "1609170265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1513 ERISWELL DR",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "957474522",
"telephone_number": "916-749-9858",
"fax_number": "916-772-0500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1513 ERISWELL DR",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "957474522",
"telephone_number": "916-749-9858",
"fax_number": "916-772-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTIT",
"first_name": "PAULA",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "LVN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-22",
"last_updated": "2010-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "CA",
"license": "244891",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.