Ma Rhea Revelina Persic

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1620 Cummins Dr
Modesto, CA 95358-6400

Phone

(209) 622-1420

Fax

(209) 491-0627

NPI assigned

Oct 18, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513296000000",
    "number": "1780195628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5507 SAVAGE AVE",
            "city": "RIVERBANK",
            "state": "CA",
            "postal_code": "95367",
            "telephone_number": "209-300-1933",
            "fax_number": "209-491-0627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 CUMMINS DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953586400",
            "telephone_number": "209-622-1420",
            "fax_number": "209-491-0627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSIC",
        "first_name": "MA RHEA",
        "middle_name": "REVELINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-18",
        "last_updated": "2017-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amit Savyon Perlin
• Shaynna Perreira
• Kristin Perrello, BA
• Cadence Perry
• Mikayla Perry
• Aftenthyn Leeander Person
• Joshua Petalio
• Pete Herron
• Peter K. Sien, MD, Inc.
• Peter S. Klem Fred P. Guarcello PTR

• Case Manager/Care Coordinator in Modesto, CA
• Providers in Modesto, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2017; 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.