Individual provider Active NPI

Maria V Pacheco, N.P.

  • Family Nurse Practitioner
  • Santa Rosa, CA
National Provider Identifier
1891920377
Registry record updated May 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8536 Issued in CA
Practice address
751 Lombardi CT # B
Santa Rosa, CA 95407-6793
Phone
(707) 547-2222
Fax
(707) 547-2229
NPI assigned
May 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8536 CA Primary

Addresses

Primary practice location

751 Lombardi CT # B
Santa Rosa, CA 95407-6793

Mailing address

751 Lombardi CT # B
Santa Rosa, CA 95407-6793
Phone (707) 547-2222

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8536CAMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243382400000",
    "number": "1891920377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 LOMBARDI CT # B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954076793",
            "telephone_number": "707-547-2222",
            "fax_number": "707-547-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 LOMBARDI CT # B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954076793",
            "telephone_number": "707-547-2222",
            "fax_number": "707-547-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "MARIA",
        "middle_name": "V",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-27",
        "last_updated": "2009-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "8536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; 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.