Individual provider Active NPI

Marjolyne Santiago Sales

  • Family Nurse Practitioner
  • Paramount, CA
National Provider Identifier
1942661772
Registry record updated Mar 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95003929 Issued in CA
Practice address
8638 Rancho Vista St
Paramount, CA 90723-4582
Phone
(562) 413-5760
NPI assigned
Mar 7, 2016
Last updated
Mar 7, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95003929 CA Primary
Emergency Registered Nurse 163WE0003X 632870 CA

Addresses

Primary practice location

8638 Rancho Vista St
Paramount, CA 90723-4582

Mailing address

8638 Rancho Vista St
Paramount, CA 90723-4582
Phone (562) 413-5760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170921001222 CA Practitioner - Nurse Practitioner 2567736002 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
632870CAMDEmergency Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Reproductive Health Care Center CurrentSince Aug 7, 2017 Accepting new patients
Reproductive Health Care Center CurrentSince Aug 7, 2017 Accepting new patients

Locations

501 S Brookhurst Rd
Fullerton, CA 92833
Phone (714) 870-0717

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1457308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457308800000",
    "number": "1942661772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8638 RANCHO VISTA ST",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907234582",
            "telephone_number": "562-413-5760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8638 RANCHO VISTA ST",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907234582",
            "telephone_number": "562-413-5760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALES",
        "first_name": "MARJOLYNE",
        "middle_name": "SANTIAGO",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-07",
        "last_updated": "2016-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003929",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "CA",
            "license": "632870",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramount, CA

Sources for this page

Verify at the official NPI Registry.