Thanhan Mathews, NP
Individual provider Active NPI Primary Care Nurse Practitioner · Avenal, CA
NPI 1942811377 · NPPES record last updated Mar 18, 2023
Key facts
- NPI
- 1942811377
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- 835965 (CA)
- Practice address
- 148 E Kings St
Avenal, CA 93204-1529 - Phone
- (559) 386-9000
- NPI assigned
- Aug 10, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220318000275 | CA | Order and Referring Only - Nurse Practitioner | 9234524877 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 835965 | CA | Yes |
Addresses
Primary practice location
148 E Kings St
Avenal, CA 93204-1529
Mailing address
555 E St
Lemoore, CA 93245-2617
Phone (559) 386-4500
Other providers in Avenal, CA
- Don Glen Lindquist
- Estela Lopez
- Jovanna Maldonado
- Levi Josiah Mariano
- Elizabeth Anne Martin
- Medicos Unidos de Avenal
- Donald Cameron Moody
- Chelsea M Mora
- Maria Moreno
- Pratap Narayan
All providers in Avenal, CA · Primary Care Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.