NPIMap

Organization Active NPI

Eagleviewpsychiatry

  • Psychiatry Physician
  • Sacramento, CA
National Provider Identifier
1700668845
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
EAGLEVIEWPSYCHIATRY
Practice address
428 J St Ste 400
Sacramento, CA 95814-2394
Phone
(916) 999-1418
Fax
(916) 288-8886
NPI assigned
Oct 13, 2023
Last updated
May 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Authorized official

Name
Manvir PannuNPI 1497439640
Title
Owner
Phone
(916) 999-1418

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
Psychiatry Physician 2084P0800X Primary

Addresses

Primary practice location

428 J St Ste 400
Sacramento, CA 95814-2394

Mailing address

8765 Heritage Hill Dr
Elk Grove, CA 95624-3945
Phone (916) 999-1418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240103000553 CA Part B Supplier - Clinic/Group Practice 5496105413 Receives reassigned benefits from 1 practitioner
Practice locations: Sacramento, CA
O20240809003414 CA Part B Supplier - Clinic/Group Practice 8921546862 Receives reassigned benefits from 7 practitioners
Practice locations: Yuba City, CA; San Jose, CA; Sacramento, CA; Elk Grove, CA

National Provider Directory

National Provider Directory

Locations

1325 Howe Ave
Ste 101
Sacramento, CA 95825
Phone (916) 927-3137

2880 Zanker Rd
Ste 208
San Jose, CA 95134
Phone (916) 999-1418

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1697155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1700668845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8765 HERITAGE HILL DR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956243945",
            "telephone_number": "916-999-1418",
            "fax_number": "916-288-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 J ST STE 400",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958142394",
            "telephone_number": "916-999-1418",
            "fax_number": "916-288-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLEVIEWPSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-13",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "PANNU",
        "authorized_official_first_name": "MANVIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-999-1418"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.