Keri Lynn Gonsalves, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

696292 Issued in CA

Practice address

8645 North Lake Blvd.
#C
Kings Beach, CA 96143

Phone

(530) 546-4956

NPI assigned

Mar 12, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Keri Lynn Rider Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1700057239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8645 NORTH LAKE BLVD.",
            "address_2": "#C",
            "city": "KINGS BEACH",
            "state": "CA",
            "postal_code": "96143",
            "telephone_number": "530-546-4956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8645 NORTH LAKE BLVD.",
            "address_2": "#C",
            "city": "KINGS BEACH",
            "state": "CA",
            "postal_code": "96143",
            "telephone_number": "530-546-4956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONSALVES",
        "first_name": "KERI",
        "middle_name": "LYNN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-12",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "696292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERI",
            "last_name": "RIDER",
            "middle_name": "LYNN",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Richard Vanhalen Collins II, PHARMD
• County of Placer
• Nyla Davis, R.PH.
• Eileen Anne Driscoll-Norman, D.C.
• Jeanne Ehrhart, DDS
• Granite Wellness Centers
• Joel Grimwood, D.C.
• Rocio Gutierrez
• Karla M Juarez
• Seson Kahn, FNP

• Registered Nurse in Kings Beach, CA
• Providers in Kings Beach, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.