Individual provider Active NPI

Mari Cam VI Nguyen Hvezda, RPH

  • Pharmacist
  • West Sacramento, CA
National Provider Identifier
1770033060
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
75663 Issued in CA
Practice address
1601 W Capitol Ave
West Sacramento, CA 95691-3219
Phone
(916) 372-3111
NPI assigned
Oct 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 75663 CA Primary

Addresses

Primary practice location

1601 W Capitol Ave
West Sacramento, CA 95691-3219

Mailing address

1601 W Capitol Ave
West Sacramento, CA 95691-3219
Phone (916) 372-3111

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 Pharmacist

State licenses

LicenseStateTypeSpecialty
75663CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Raleys PastSince Sep 13, 2020 Accepting new patients
Longs Drug Store California LLC Past Accepting new patients
Longs Drug Stores California LLC Past Accepting new patients
Raleys PastSince Sep 13, 2020 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1770033060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 W CAPITOL AVE",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956913219",
            "telephone_number": "916-372-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 W CAPITOL AVE",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956913219",
            "telephone_number": "916-372-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HVEZDA",
        "first_name": "MARI CAM VI",
        "middle_name": "NGUYEN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-11",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "75663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; 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.