Active NPI
Cristina Labao Mallari, RN
- General Practice Registered Nurse
- Fairfield, CA
National Provider Identifier
1861086720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Registered Nurse
- License
- 95142287
- Practice address
- 5065 Soprano Cir
Fairfield, CA 94534-6897 - Phone
- (224) 817-5962
- NPI assigned
- Feb 22, 2021
- 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 |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | 95142287 | CA | Primary |
Addresses
Primary practice location
5065 Soprano Cir
Fairfield, CA 94534-6897
Mailing address
5065 Soprano Cir
Fairfield, CA 94534-6897
Phone (224) 817-5962
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95142287 | CA | MD | General Practice Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adya Hospice & Palliative Care, LLC | Current | Accepting new patients | |
| Jem C Enterprises LLC | Current | Accepting new patients |
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.
-
- Home Health Agency
- Fairfield, CA
- NPI 1538989892
-
- Community Based Hospice Care Agency
- Fairfield, CA
- NPI 1891327573
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613952000000",
"number": "1861086720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5065 SOPRANO CIR",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945346897",
"telephone_number": "224-817-5962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5065 SOPRANO CIR",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945346897",
"telephone_number": "224-817-5962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLARI",
"first_name": "CRISTINA",
"middle_name": "LABAO",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-22",
"last_updated": "2021-02-22",
"certification_date": "2021-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "CA",
"license": "95142287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.