Individual provider Active NPI

Terrance Sisco

  • Driver
  • Folsom, CA
National Provider Identifier
1861200362
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
C4267060 Issued in CA
Practice address
9580 Oak Avenue Pkwy Ste 7-162
Folsom, CA 95630-1888
Phone
(714) 322-1344
NPI assigned
Dec 30, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X C4267060 CA Primary

Addresses

Primary practice location

9580 Oak Avenue Pkwy Ste 7-162
Folsom, CA 95630-1888

Mailing address

9580 Oak Avenue Pkwy Ste 7-162
Folsom, CA 95630-1888
Phone (714) 322-1344

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

State licenses

LicenseStateTypeSpecialty
C4267060CAMDDriver

Practice roles

OrganizationSpecialtyStatusNew patients
Vigilant Physicians Readers, Inc Current Accepting new patients
Satellite Medical Inc CurrentSince Jan 5, 2025 Accepting new patients
Synergy Iom, LLC Current Accepting new patients
Satellite Medical LLC CurrentSince Jan 5, 2025 Accepting new patients

Locations

9580 Oak Avenue Pkwy
Ste 7162
Folsom, CA 95630
Phone (619) 393-5299

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1735516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1861200362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9580 OAK AVENUE PKWY STE 7-162",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956301888",
            "telephone_number": "714-322-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9580 OAK AVENUE PKWY STE 7-162",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956301888",
            "telephone_number": "714-322-1344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISCO",
        "first_name": "TERRANCE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-30",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "CA",
            "license": "C4267060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.