Molly Mack, NP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

95007144 Issued in CA

Practice address

1416 El Centro St
South Pasadena, CA 91030-3202

Phone

(626) 577-2229

NPI assigned

Aug 29, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509408000000",
    "number": "1952828915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 EL CENTRO ST",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910303202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 EL CENTRO ST",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910303202",
            "telephone_number": "626-577-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "MOLLY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-29",
        "last_updated": "2017-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "95007144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence Mark Lyons, LCSW
• Lien Ma
• James A Maccuish, M.D.
• Casey Roagan Macgregor-Toshima, PHD
• Marcia Machol, LCSW
• Laura Macrae-Serpa, LMFT
• Maria Guadalupe Magos
• Lauren Maher, LMFT
• Noah Spencer Mahood
• Maral M Malekian

• Women's Health Nurse Practitioner in South Pasadena, CA
• Providers in South Pasadena, CA by specialty
• Women's Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; 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.