Mary Wallace Howell, PAC FNP

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA14001 Issued in CA

Practice address

2330 W Covell Blvd Ste 100
Davis, CA 95616

Phone

(530) 668-2660

Fax

(530) 756-5817

NPI assigned

Jun 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1790725075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 W GIBSON RD",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956955169",
            "telephone_number": "530-666-1631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 W COVELL BLVD STE 100",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "95616",
            "telephone_number": "530-668-2660",
            "fax_number": "530-756-5817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWELL",
        "first_name": "MARY",
        "middle_name": "WALLACE",
        "credential": "PAC FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP8902",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA14001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "PA14001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Honig, CHW
• Rebekah Jo Honig, MS
• Rebecca Marie Horton
• Teena Ann Hosey, LCSW
• Laura A Howard, MD
• Miranda Hower, COTA
• Johanna Hsieh
• Myra Qi-Hua Hu
• Daphne L. Huang, D.P.M.
• Emily Huang

• Physician Assistant in Davis, CA
• Providers in Davis, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; 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.