Active NPI
Marjolyne Santiago Sales
- Family Nurse Practitioner
- Paramount, CA
National Provider Identifier
1942661772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95003929
- Practice address
- 8638 Rancho Vista St
Paramount, CA 90723-4582 - Phone
- (562) 413-5760
- NPI assigned
- Mar 7, 2016
- Last updated
- Mar 7, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 632870 | CA | MD | Emergency Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reproductive Health Care Center | Current | Accepting new patients | |
| Reproductive Health Care Center | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.