Individual provider Active NPI

Deanne Manansala, NP

  • Women's Health Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1770036519
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
440095 Issued in CA
Practice address
4100 E Commerce Way Ste 110
Sacramento, CA 95834-9501
Phone
(916) 515-1698
NPI assigned
Jul 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 440095 CA Primary

Addresses

Primary practice location

4100 E Commerce Way Ste 110
Sacramento, CA 95834-9501

Mailing address

2420 El Pavo Way
Rancho Cordova, CA 95670-3132
Phone (916) 708-1623

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
440095CAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Perspectives, Inc. Past Accepting new patients
Professional Medical Clinic for Women-Sacramento, Inc. PastSince May 23, 2008 Accepting new patients
Wellspace Health Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dmanansala769560@direct.ochin.org

Organizations & group practices 3

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": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1770036519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 EL PAVO WAY",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956703132",
            "telephone_number": "916-708-1623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 E COMMERCE WAY STE 110",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958349501",
            "telephone_number": "916-515-1698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANANSALA",
        "first_name": "DEANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-28",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "440095",
            "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 Jul 28, 2016; 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.