Active NPI
Raana Sidky
- Pharmacist
- Riverside, CA
National Provider Identifier
1891107850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 57613
- Practice address
- 3975 Jackson St Ste 109
Riverside, CA 92503-3946 - Phone
- (951) 637-0180
- NPI assigned
- May 27, 2014
- Last updated
- Feb 21, 2020
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 57613 | CA | Primary |
Addresses
Primary practice location
3975 Jackson St Ste 109
Riverside, CA 92503-3946
Mailing address
13840 Star Gazer CT
Corona, CA 92880-3221
Phone (951) 818-2330
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Riverside |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 57613 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sirisansh LLC | Past | Accepting new patients | |
| Fullerton Pharmacy, Inc. | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582243200000",
"number": "1891107850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13840 STAR GAZER CT",
"city": "CORONA",
"state": "CA",
"postal_code": "928803221",
"telephone_number": "951-818-2330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3975 JACKSON ST STE 109",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925033946",
"telephone_number": "951-637-0180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIDKY",
"first_name": "RAANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-27",
"last_updated": "2020-02-21",
"certification_date": "2020-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "57613",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Riverside",
"affiliation": "N",
"address_1": "3975 Jackson St Ste 109",
"city": "Riverside",
"state": "CA",
"country_code": "US",
"postal_code": "925033946",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.