Active NPI
Colleen A Phalen, NPI
- Psychiatric/Mental Health Nurse Practitioner
- Auburn, CA
National Provider Identifier
1639354772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 18390
- Practice address
- 1111 High St
Auburn, CA 95603-5151 - Phone
- (530) 885-5177
- NPI assigned
- Jan 8, 2008
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 355373CP | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 18390 | CA | Primary |
Addresses
Primary practice location
1111 High St
Auburn, CA 95603-5151
Mailing address
1111 High St
Auburn, CA 95603-5151
Phone (530) 885-5177
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 1, 2014 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 355373CP | CA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456185600000",
"number": "1639354772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 HIGH ST",
"city": "AUBURN",
"state": "CA",
"postal_code": "956035151",
"telephone_number": "530-885-5177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 HIGH ST",
"city": "AUBURN",
"state": "CA",
"postal_code": "956035151",
"telephone_number": "530-885-5177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHALEN",
"first_name": "COLLEEN",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "NPI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-08",
"last_updated": "2016-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "355373CP",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CA",
"license": "18390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.