Debra Mutopo, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95010992 Issued in CA

Practice address

900 Mountain Ranch Rd
San Andreas, CA 95249-9713

Phone

(209) 754-3823

NPI assigned

Mar 29, 2019

Last updated

Jun 6, 2019By 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)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1891256947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1569",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "952491569",
            "telephone_number": "209-745-3823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MOUNTAIN RANCH RD",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "952499713",
            "telephone_number": "209-754-3823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTOPO",
        "first_name": "DEBRA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95010992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Lee Morgan-Yount, ACSW
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• Robert Kenneth Mulert, M.D.
• Zachery Richard Murton, MFT INTERN
• Melody W Nelson, MT-BC
• Tracy My Ngo
• Todd Israel Nosanow
• Carla R O'Dell
• Christina O'Flinn, RN

• Family Nurse Practitioner in San Andreas, CA
• Providers in San Andreas, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2019; 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.