Active NPI
Liezel Bersamina, NURSE PRACTITIONER
- Family Nurse Practitioner
- Fair Oaks, CA
National Provider Identifier
1912310046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 13849
- Practice address
- 6600 Mercy CT Ste 100
Fair Oaks, CA 95628-3154 - Phone
- (916) 966-5404
- Fax
- (916) 966-5411
- NPI assigned
- Jun 5, 2014
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 13849 | CA | Primary |
Addresses
Primary practice location
6600 Mercy CT Ste 100
Fair Oaks, CA 95628-3154
Mailing address
6600 Mercy CT Ste 100
Fair Oaks, CA 95628-3154
Phone (916) 966-5404
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 |
|---|---|---|---|
| 13849 | CA | MD | Speech-Language Pathologist |
Interoperability endpoints
- lbersamina15408@hpmg.direct-ci.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401926400000",
"number": "1912310046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6600 MERCY CT STE 100",
"city": "FAIR OAKS",
"state": "CA",
"postal_code": "956283154",
"telephone_number": "916-966-5404",
"fax_number": "916-966-5411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6600 MERCY CT STE 100",
"city": "FAIR OAKS",
"state": "CA",
"postal_code": "956283154",
"telephone_number": "916-966-5404",
"fax_number": "916-966-5411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERSAMINA",
"first_name": "LIEZEL",
"name_prefix": "Ms.",
"credential": "NURSE PRACTITIONER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-05",
"last_updated": "2014-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "13849",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fair Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.