Mary Worrall Gallegos, RN, BSN, CHPN, PHN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

372570 Issued in CA

Practice address

90 Via Juana Lane
C/O Santa Ynez Tribal Health Clinic
Santa Ynez, CA 93460

Phone

(805) 688-7070

Fax

(805) 686-2060

NPI assigned

May 30, 2012

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

Other names 1

• Mary Worrall Hanson Former name

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

Practice roles

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.

• Santa Ynez Band of Mission Indians

  • Federally Qualified Health Center (FQHC)
  • Santa Ynez, CA
  • NPI 1992779417
  NPD (past)

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338336000000",
    "number": "1619238367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 539",
            "address_2": "C/O SANTA YNEZ TRIBAL HEALTH CLINIC",
            "city": "SANTA YNEZ",
            "state": "CA",
            "postal_code": "93460",
            "telephone_number": "805-688-7070",
            "fax_number": "805-686-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 VIA JUANA LANE",
            "address_2": "C/O SANTA YNEZ TRIBAL HEALTH CLINIC",
            "city": "SANTA YNEZ",
            "state": "CA",
            "postal_code": "93460",
            "telephone_number": "805-688-7070",
            "fax_number": "805-686-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "MARY",
        "middle_name": "WORRALL",
        "name_prefix": "Mrs.",
        "credential": "RN, BSN, CHPN, PHN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-30",
        "last_updated": "2012-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "372570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "HANSON",
            "middle_name": "WORRALL",
            "credential": "RN, PHN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Faith Anne Deeter, MFT
• Nina Angela Downie, MPT
• Christine Ann Duis, PHD
• Deborah E Eckles, RN
• Dwayne Arthur Elder, D.D.S.
• Eric Michael George, DMD
• James Edgar Hazard Jr., DC
• Herbert M Janklow, MD a Professional Corporation
• Herbert Michael Janklow, MD
• Quiana Tamil Lewis, RN

• All providers in Santa Ynez, CA
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; 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.