Individual provider Active NPI

Sia Mariama Komba, R.N.

  • Registered Nurse
  • San Jose, CA
National Provider Identifier
1861831828
Registry record updated Jun 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
824535 Issued in CA
Practice address
481 Verano CT
San Jose, CA 95111-3847
Phone
(408) 239-4123
NPI assigned
Jun 22, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 824535 CA Primary

Addresses

Primary practice location

481 Verano CT
San Jose, CA 95111-3847

Mailing address

481 Verano CT
San Jose, CA 95111-3847
Phone (408) 239-4123

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

LicenseStateTypeSpecialty
824535CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1371859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371859200000",
    "number": "1861831828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 VERANO CT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951113847",
            "telephone_number": "408-239-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 VERANO CT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951113847",
            "telephone_number": "408-239-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMBA",
        "first_name": "SIA",
        "middle_name": "MARIAMA",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-22",
        "last_updated": "2013-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "824535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2013; 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.