Active NPI
Marissa Reynoso, CRNA
- Certified Registered Nurse Anesthetist
- Union City, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 95000694
- Practice address
- 3138 Chimney CT
Union City, CA 94587-1650 - Phone
- (510) 449-7738
- NPI assigned
- Jan 5, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 95000694 | CA | Primary |
Addresses
Primary practice location
3138 Chimney CT
Union City, CA 94587-1650
Mailing address
3151 S St Apt 340
Sacramento, CA 95816-7075
Phone (510) 449-7738
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1700 San Pablo Ave
Suite D
Pinole, CA 94564-2082
Phone (510) 724-9500
6600 Bruceville Rd
Sacramento, CA 95823-4671
Phone (916) 688-2000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95000694 | CA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mai Nursing Anesthesia PC | Current | Accepting new patients | |
| Permanente Medical Group Inc | Current | Accepting new patients |
Locations
750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131
429 Llewellyn Ave
Campbell, CA 95008
Phone (408) 358-5000
1700 San Pablo Ave
Ste D
Pinole, CA 94564
Phone (510) 724-9500
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
6600 Bruceville Rd
Sacramento, CA 95823
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
3003 Paul Sweet Rd
Santa Cruz, CA 95065
Phone (831) 462-1607
1720 4th St
Santa Rosa, CA 95404
Phone (707) 546-8100
3540 Mendocino Ave
Ste 200
Santa Rosa, CA 95403
Phone (707) 522-6200
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
2160 W Grant Line Rd
Ste 120
Tracy, CA 95377
Phone (209) 832-2095
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- San Francisco, CA
- NPI 1003572769
-
- Internal Medicine Physician
- Santa Clara, CA
- NPI 1073606299
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1483574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691020800000",
"number": "1851836472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3151 S ST APT 340",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958167075",
"telephone_number": "510-449-7738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3138 CHIMNEY CT",
"city": "UNION CITY",
"state": "CA",
"postal_code": "945871650",
"telephone_number": "510-449-7738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOSO",
"first_name": "MARISSA",
"name_prefix": "Ms.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-05",
"last_updated": "2023-08-03",
"certification_date": "2023-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "CA",
"license": "95000694",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "The Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "6600 Bruceville Rd",
"city": "Sacramento",
"state": "CA",
"country_code": "US",
"postal_code": "958234671",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Union City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.