Individual provider Active NPI

Sandra Kamba

  • Primary Care Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1962134692
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
NP95021536 Issued in CA
Practice address
965 El Camino Ave
Sacramento, CA 95815-2530
Phone
(916) 642-1867
NPI assigned
Jun 30, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 95065306 CA
Primary Care Nurse Practitioner 363LP2300X NP95021536 CA Primary

Addresses

Primary practice location

965 El Camino Ave
Sacramento, CA 95815-2530

Mailing address

7708 E Port Dr
Sacramento, CA 95831-5613
Phone (323) 620-6484

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
I20240327000701 CA Practitioner - Nurse Practitioner 4385020429 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95021536CAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Sacramento CurrentSince Mar 1, 2024 Accepting new patients
Regents of the University of California CurrentSince May 1, 2025 Accepting new patients
County of Sacramento CurrentSince Mar 1, 2024 Accepting new patients
Regents of the University of California CurrentSince May 1, 2025 Accepting new patients
Essent PRMC LP Past Accepting new patients

Locations

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

3160 Folsom Blvd
Ste 1400
Sacramento, CA 95816
Phone (916) 731-1831

4600 Broadway
Sacramento, CA 95820
Phone (916) 874-9670

4600 Broadway
#1100
Sacramento, CA 95820
Phone (916) 874-9670

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1962134692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7708 E PORT DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958315613",
            "telephone_number": "323-620-6484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 EL CAMINO AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958152530",
            "telephone_number": "916-642-1867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMBA",
        "first_name": "SANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-30",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "95065306",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "NP95021536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.