Individual provider Active NPI

Mary Khadaran, RN

  • Registered Nurse
  • San Mateo, CA
National Provider Identifier
1689594624
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95372598 Issued in CA
Practice address
1875 S Grant St Ste 760
San Mateo, CA 94402-2670
Phone
(888) 227-8884
NPI assigned
Jul 20, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95372598 CA Primary

Addresses

Primary practice location

1875 S Grant St Ste 760
San Mateo, CA 94402-2670

Mailing address

1875 S Grant St Ste 760
San Mateo, CA 94402-2670
Phone (888) 227-8884

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

NPI Registry JSON

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

{
    "created_epoch": "1784505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1689594624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 S GRANT ST STE 760",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022670",
            "telephone_number": "888-227-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 S GRANT ST STE 760",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022670",
            "telephone_number": "888-227-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHADARAN",
        "first_name": "MARY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-20",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95372598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; 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.