Individual provider Active NPI

Sara Pourmand

  • Family Nurse Practitioner
  • San Clemente, CA
National Provider Identifier
1811779689
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95026191 Issued in CA
Practice address
638 Camino de Los Mares
San Clemente, CA 92673-2848
Phone
(866) 389-2727
NPI assigned
Oct 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95026191 CA Primary

Addresses

Primary practice location

638 Camino de Los Mares
San Clemente, CA 92673-2848

Mailing address

638 Camino de Los Mares
San Clemente, CA 92673-2848
Phone (866) 389-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250527000520 CA Order and Referring Only - Nurse Practitioner 1850740333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95026191CAMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: sarapourmand@chcca.allscriptsdirect.net

NPI Registry JSON

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

{
    "created_epoch": "1697500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1811779689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 CAMINO DE LOS MARES",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732848",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 CAMINO DE LOS MARES",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732848",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POURMAND",
        "first_name": "SARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-17",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95026191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

Verify at the official NPI Registry.