Individual provider Active NPI

Marilyn Evelyn Fortin, REG NURSE

  • Registered Nurse
  • Salinas, CA
National Provider Identifier
1699074930
Registry record updated Mar 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
68971 Issued in CA
Practice address
1441 Constitution Blvd BLDG 400
Suite 202
Salinas, CA 93906-3100
Phone
(831) 796-1700
Fax
(831) 769-0552
NPI assigned
Mar 25, 2011
Last updated
Mar 25, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2011

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 68971 CA Primary

Addresses

Primary practice location

1441 Constitution Blvd BLDG 400
Suite 202
Salinas, CA 93906-3100

Mailing address

1441 Constitution Blvd BLDG 400
Suite 202
Salinas, CA 93906-3100
Phone (831) 796-1700

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
68971CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1301011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301011200000",
    "number": "1699074930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 CONSTITUTION BLVD BLDG 400",
            "address_2": "SUITE 202",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939063100",
            "telephone_number": "831-796-1700",
            "fax_number": "831-769-0552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 CONSTITUTION BLVD BLDG 400",
            "address_2": "SUITE 202",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939063100",
            "telephone_number": "831-796-1700",
            "fax_number": "831-769-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTIN",
        "first_name": "MARILYN",
        "middle_name": "EVELYN",
        "name_prefix": "Ms.",
        "credential": "REG NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-25",
        "last_updated": "2011-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "68971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salinas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.