Selena Tina Patolo

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

761874 Issued in CA

Practice address

1804 Evergreen Ave
West Sacramento, CA 95691-3108

Phone

(925) 305-6548

NPI assigned

Jan 9, 2014

Last updated

Jan 9, 2014By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• MMM Bay Area Transportation

  • Non-emergency Medical Transport (VAN)
  • Oakley, CA
  • NPI 1497689764
  NPD Authorized official

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

{
    "created_epoch": "1389225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389225600000",
    "number": "1891117800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 EVERGREEN AVE",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956913108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 EVERGREEN AVE",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956913108",
            "telephone_number": "925-305-6548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATOLO",
        "first_name": "SELENA",
        "middle_name": "TINA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-09",
        "last_updated": "2014-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "761874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Parella
• Ju Yeon Park, DDS
• Lisa C Parker
• Rosemary Eileen Parker, ACSW
• Tracy Kristin Parsons, MS PT
• Patricia Temple
• Paul a. Johnson DDS Inc (Pediatric Dentistry of West Sacramento)
• Guadalupe Domenica Pelayo Benyamino
• Erica Pelayo
• Liana Penafiel Wonsang, DDS

• Registered Nurse in West Sacramento, CA
• Providers in West Sacramento, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; 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.