Individual provider Active NPI

Mary I. Daniels, RN, MPH

  • Registered Nurse
  • Perris, CA
National Provider Identifier
1679851588
Registry record updated Jul 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
433847 Issued in CA
Practice address
308 E San Jacinto Ave
Suite 80
Perris, CA 92570-2878
Phone
(951) 210-1386
NPI assigned
Jul 26, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X 433847 CA Primary

Addresses

Primary practice location

308 E San Jacinto Ave
Suite 80
Perris, CA 92570-2878

Mailing address

1903 Roanoke St
San Jacinto, CA 92582-6918
Phone (951) 654-4922

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
433847CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1311638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311638400000",
    "number": "1679851588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 ROANOKE ST",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925826918",
            "telephone_number": "951-654-4922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 E SAN JACINTO AVE",
            "address_2": "SUITE 80",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925702878",
            "telephone_number": "951-210-1386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "MARY",
        "middle_name": "I.",
        "name_prefix": "Ms.",
        "credential": "RN, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-26",
        "last_updated": "2011-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "433847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perris, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; 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.