Individual provider Active NPI

Andrea Packheiser

  • Pharmacist
  • West Sacramento, CA
National Provider Identifier
1972372274
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
48819 Issued in CA
Practice address
970 Riverside Pkwy Ste 20
West Sacramento, CA 95605-1508
Phone
(916) 636-8943
NPI assigned
Dec 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 48819 CA Primary

Addresses

Primary practice location

970 Riverside Pkwy Ste 20
West Sacramento, CA 95605-1508

Mailing address

970 Riverside Pkwy Ste 20
West Sacramento, CA 95605-1508
Phone (916) 636-8943

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
48819CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1703721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1972372274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 RIVERSIDE PKWY STE 20",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956051508",
            "telephone_number": "916-636-8943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 RIVERSIDE PKWY STE 20",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956051508",
            "telephone_number": "916-636-8943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKHEISER",
        "first_name": "ANDREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-28",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "48819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; 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.