Mariejoy B Supapo, BSN

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

607207 Issued in CA

Practice address

275 Beck Avenue Ms 5-240
Fairfield, CA 94533-6804

Phone

(707) 784-8070

Fax

(707) 435-2500

NPI assigned

Jan 3, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing

State licenses

Practice roles

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.

• Solano County Health and Social Services

  • Public Health or Welfare Agency
  • Fairfield, CA
  • NPI 1891851317
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861559239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 BECK AVENUE MS 5-240",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336804",
            "telephone_number": "707-784-8070",
            "fax_number": "707-435-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 BECK AVENUE MS 5-240",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336804",
            "telephone_number": "707-784-8070",
            "fax_number": "707-435-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPAPO",
        "first_name": "MARIEJOY",
        "middle_name": "B",
        "credential": "BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "607207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "607207",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arianne Summers
• Summerville at Cobbco, Inc.
• Hunter Sumner
• Bruce Sunberg
• Liana Sunday
• Super Care, LLC
• Superior Court of California County of Solano
• Surgical Imaging Services Inc.
• Ronald Susa, PHARMD
• Mark R Susskind, MD

• Community Health Registered Nurse in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Community Health Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.