Individual provider Active NPI

Laurissa Haydu, RN, PHN

  • Public Health & General Preventive Medicine Physician
  • Sacramento, CA
National Provider Identifier
1700677440
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
PHN563291 Issued in CA
Practice address
9616 Micron Ave Ste 970
Sacramento, CA 95827-2627
Phone
(530) 387-1834
NPI assigned
May 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X PHN563291 CA Primary

Addresses

Primary practice location

9616 Micron Ave Ste 970
Sacramento, CA 95827-2627

Mailing address

9616 Micron Ave Ste 970
Sacramento, CA 95827-2627
Phone (530) 387-1834

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
PHN563291CAMDPublic Health & General Preventive Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1747094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1700677440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9616 MICRON AVE STE 970",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272627",
            "telephone_number": "530-387-1834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9616 MICRON AVE STE 970",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272627",
            "telephone_number": "530-387-1834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYDU",
        "first_name": "LAURISSA",
        "credential": "RN, PHN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-13",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "CA",
            "license": "PHN563291",
            "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 13, 2025; 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.