Individual provider Active NPI

Carmencita U Delacruz, RRT, NPS, BS BIOLOGY

  • Neonatal/Pediatric Certified Respiratory Therapist
  • Fairfield, CA
National Provider Identifier
1689138380
Registry record updated Jan 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal/Pediatric Certified Respiratory TherapistTaxonomy code 2278P3900X
License
18128 Issued in CA
Practice address
2916 Rebecca Dr
Fairfield, CA 94533-7035
Phone
(707) 386-5397
NPI assigned
Jan 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal/Pediatric Certified Respiratory Therapist 2278P3900X 18128 CA Primary

Addresses

Primary practice location

2916 Rebecca Dr
Fairfield, CA 94533-7035

Mailing address

975 Sereno Dr
Vallejo, CA 94589-2441
Phone (707) 651-1318

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
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
18128CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1548547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548547200000",
    "number": "1689138380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 SERENO DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892441",
            "telephone_number": "707-651-1318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2916 REBECCA DR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945337035",
            "telephone_number": "707-386-5397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELACRUZ",
        "first_name": "CARMENCITA",
        "middle_name": "U",
        "credential": "RRT, NPS, BS BIOLOGY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-27",
        "last_updated": "2019-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2278P3900X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Certified, Neonatal/Pediatrics",
            "state": "CA",
            "license": "18128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2019; 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.