Individual provider Active NPI

Stephen Asiain Tatom, CNOR, RNFA

  • Registered Nurse First Assistant
  • Vallejo, CA
National Provider Identifier
1629404744
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
612883 Issued in CA
Practice address
300 Hospital Dr
Sutter Solano Medical Center
Vallejo, CA 94589-2574
Phone
(707) 554-5305
NPI assigned
Sep 20, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 612883 CA Primary

Addresses

Primary practice location

300 Hospital Dr
Sutter Solano Medical Center
Vallejo, CA 94589-2574

Mailing address

5055 Business Center Dr
Suite 108 - Ups Store - PMB 258
Fairfield, CA 94534-1643
Phone (707) 319-2462

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

LicenseStateTypeSpecialty
612883CAMDRegistered Nurse First Assistant

NPI Registry JSON

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1629404744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5055 BUSINESS CENTER DR",
            "address_2": "SUITE 108 - UPS STORE - PMB 258",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945341643",
            "telephone_number": "707-319-2462",
            "fax_number": "707-998-7632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HOSPITAL DR",
            "address_2": "SUTTER SOLANO MEDICAL CENTER",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892574",
            "telephone_number": "707-554-5305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATOM",
        "first_name": "STEPHEN",
        "middle_name": "ASIAIN",
        "name_prefix": "Mr.",
        "credential": "CNOR, RNFA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-20",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "CA",
            "license": "612883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; 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.