Active NPI
Darla Jo Mabery, D.O.
- General Practice Physician
- Roseville, CA
National Provider Identifier
1972702033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 20A5894
- Practice address
- 1158 Cirby Way
Suite B
Roseville, CA 95661-4478 - Phone
- (916) 774-7348
- Fax
- (916) 774-1556
- NPI assigned
- Jul 17, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 20A5894 | CA | Primary |
Addresses
Primary practice location
1158 Cirby Way
Suite B
Roseville, CA 95661-4478
Mailing address
1158 Cirby Way
Suite B
Roseville, CA 95661-4478
Phone (916) 774-7348
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A5894 | CA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184630400000",
"number": "1972702033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1158 CIRBY WAY",
"address_2": "SUITE B",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956614478",
"telephone_number": "916-774-7348",
"fax_number": "916-774-1556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1158 CIRBY WAY",
"address_2": "SUITE B",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956614478",
"telephone_number": "916-774-7348",
"fax_number": "916-774-1556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MABERY",
"first_name": "DARLA",
"middle_name": "JO",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-17",
"last_updated": "2007-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "20A5894",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roseville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.