Individual provider Active NPI

Mark Christian Sampang

  • Psychiatric/Mental Health Nurse Practitioner
  • Cerritos, CA
National Provider Identifier
1609224708
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95004292 Issued in CA
Practice address
19706 Ray Cir
Cerritos, CA 90703-7546
Phone
(562) 805-8229
NPI assigned
May 31, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 95004292 CA Primary
Family Nurse Practitioner 363LF0000X 95004292 CA

Addresses

Primary practice location

19706 Ray Cir
Cerritos, CA 90703-7546

Mailing address

12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703-9329
Phone (562) 207-0139

Other practice location 1

3628 Stockdale Hwy
Bakersfield, CA 93309-2153
Phone (661) 322-1021

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
I20170518000712 CA Practitioner - Nurse Practitioner 1951685015 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of KernGroup PAC ID 7810887205, 75 clinicians

Practice addresses (Care Compare)

2525 N Chester Ave
Bakersfield, CA 93308-1770
Phone (661) 868-1800

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Health Care and Medical Clinic, Inc. Single Specialty CurrentSince Mar 1, 2018 Accepting new patients
Albion Medical Partners of California West P C Single Specialty CurrentSince Feb 1, 2021 Accepting new patients
County of Kern CurrentSince Dec 28, 2021 Accepting new patients
County of Kern CurrentSince Dec 28, 2021 Accepting new patients
All Inclusive Medical Services, Inc Single Specialty CurrentSince Oct 2, 2017 Accepting new patients
County of Kern Single Specialty Current Accepting new patients

Locations

3628 Stockdale Hwy
Bakersfield, CA 93309
Phone (661) 322-1021

2525 N Chester Ave
Bakersfield, CA 93308
Phone (661) 328-4295

5900 Coyle Ave
Ste A
Carmichael, CA 95608
Phone (916) 330-4447

12900 Park Plaza Dr
Ste 700
Cerritos, CA 90703
Phone (562) 622-2800

12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800

1500 S Central Ave
Ste 320
Glendale, CA 91204
Phone (818) 396-5670

Organizations & group practices 6

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": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1609224708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12900 PARK PLAZA DR",
            "address_2": "STE 150",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907039329",
            "telephone_number": "562-207-0139",
            "fax_number": "562-741-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19706 RAY CIR",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907037546",
            "telephone_number": "562-805-8229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3628 Stockdale Hwy",
            "address_purpose": "LOCATION",
            "city": "Bakersfield",
            "state": "CA",
            "postal_code": "933092153",
            "country_code": "US",
            "telephone_number": "661-322-1021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMPANG",
        "first_name": "MARK CHRISTIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-31",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95004292",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95004292",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

Verify at the official NPI Registry.