Individual provider Active NPI

Elizabeth Delores Glavich, F.N.P.

  • Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1659475226
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
111720 Issued in CA
Practice address
6000 JST.
Csus-Student Health
Sacramento, CA 95819-6045
Phone
(916) 278-6461
Fax
(916) 278-7359
NPI assigned
Sep 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 111720 CA Primary

Addresses

Primary practice location

6000 JST.
Csus-Student Health
Sacramento, CA 95819-6045

Mailing address

3278 Via Grande
Sacramento, CA 95825-2004
Phone (916) 488-2567

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
111720CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659475226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3278 VIA GRANDE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252004",
            "telephone_number": "916-488-2567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 JST.",
            "address_2": "CSUS-STUDENT HEALTH",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958196045",
            "telephone_number": "916-278-6461",
            "fax_number": "916-278-7359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAVICH",
        "first_name": "ELIZABETH",
        "middle_name": "DELORES",
        "name_prefix": "Ms.",
        "credential": "F.N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "111720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.