Active NPI
Rebecca A Cordero, PA-C
- Physician Assistant
- Truckee, CA
National Provider Identifier
1992978183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA1177
- Practice address
- 10448 Donner Pass Rd
Truckee, CA 96161-0344 - Phone
- (530) 587-0198
- NPI assigned
- Apr 8, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 19691 | CA | |
| Physician Assistant | 363A00000X | PA1177 | NV | Primary |
Addresses
Primary practice location
10448 Donner Pass Rd
Truckee, CA 96161-0344
Mailing address
PO Box 3526
Olympic Valley, CA 96146-3526
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19691 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325116800000",
"number": "1992978183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3526",
"city": "OLYMPIC VALLEY",
"state": "CA",
"postal_code": "961463526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10448 DONNER PASS RD",
"city": "TRUCKEE",
"state": "CA",
"postal_code": "961610344",
"telephone_number": "530-587-0198"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORDERO",
"first_name": "REBECCA",
"middle_name": "A",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-08",
"last_updated": "2011-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "19691",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NV",
"license": "PA1177",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Truckee, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.