Active NPI
Nicole M Sprague
- Pulmonary Rehabilitation Certified Respiratory Therapist
- Alta Loma, CA
National Provider Identifier
1669844973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Rehabilitation Certified Respiratory Therapist
- License
- 35693
- Practice address
- 6581 Morocco St
Alta Loma, CA 91737-4317 - Phone
- (909) 234-0247
- Fax
- (951) 698-0062
- NPI assigned
- Oct 26, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Respiratory Therapist | 227800000X | 35693 | CA | |
| Pulmonary Rehabilitation Certified Respiratory Therapist | 2278P1005X | 35693 | CA | Primary |
Addresses
Primary practice location
6581 Morocco St
Alta Loma, CA 91737-4317
Mailing address
6581 Morocco Street
Alta Loma, CA 91737
Phone (909) 234-0247
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
| License | State | Type | Specialty |
|---|---|---|---|
| 35693 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445817600000",
"number": "1669844973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6581 MOROCCO STREET",
"city": "ALTA LOMA",
"state": "CA",
"postal_code": "91737",
"telephone_number": "909-234-0247",
"fax_number": "951-698-0062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6581 MOROCCO ST",
"city": "ALTA LOMA",
"state": "CA",
"postal_code": "917374317",
"telephone_number": "909-234-0247",
"fax_number": "951-698-0062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPRAGUE",
"first_name": "NICOLE",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-26",
"last_updated": "2015-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "227800000X",
"taxonomy_group": "",
"desc": "Respiratory Therapist, Certified",
"state": "CA",
"license": "35693",
"primary": false
},
{
"code": "2278P1005X",
"taxonomy_group": "",
"desc": "Respiratory Therapist, Certified, Pulmonary Rehabilitation",
"state": "CA",
"license": "35693",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alta Loma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.