DEIRDRE ALICE MAZZETTO (NPI# 1023580446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023580446 |
| Entity Type | Individual |
| Full Name | DEIRDRE ALICE MAZZETTO |
| Other Name | DEIRDRE ALICE SULLIVAN |
| Credential | NP, AGACNP-BC |
| Practice Address |
3860 El Dorado Hills Blvd El Dorado Hills CA 95762 |
| Mailing Address |
391 Howe Ave Ste 150 Sacramento CA 95825-5513 |
| Practice Telephone | 9169419222 |
| Mailing Telephone | 9166785280 |
| Enumeration Date | 2018-12-24 |
| Last Update Date | 2019-09-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
95010718 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2800 L St Fl 6, Sacramento, CA 958165616 | 9168874040 | 9168874045 |
| 3860 El Dorado Hills Blvd, El Dorado Hills, CA 957624563 | 9169419222 |
| Street Address |
3860 EL DORADO HILLS BLVD |
| City | EL DORADO HILLS |
| State | CA |
| Zip Code | 95762 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326126004 | Jon M. Moness | Internal Medicine | 3860 El Dorado Hills Blvd, Suit # 601, El Dorado Hills, CA 95762-5507 | 2006-11-01 |
| 1538638523 | Sheryl Gerales | Nurse Practitioner | 3860 El Dorado Hills Blvd, El Dorado Hills, CA 95762-4563 | 2018-11-19 |
| 1427421122 | Mdstat Urgent Care, Inc | Clinic/Center | 3860 El Dorado Hills Blvd, Suite 601, El Dorado Hills, CA 95762-4563 | 2015-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720611163 | Melanie Kim Dental Corporation | Dentist | 3381 Bass Lake Rd, Suite 140, El Dorado Hills, CA 95762 | 2020-02-13 |
| 1063042083 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 3383 Bass Lake Rd, El Dorado Hills, CA 95762 | 2020-01-17 |
| 1427557230 | California Joint & Spine, LLC | Clinic/Center | 8135 Saratoga Way, El Dorado Hills, CA 95762 | 2018-02-07 |
| 1871008433 | Claire Maurenn Goss | Psychologist | 5406 Da Vinci Drive, El Dorado Hills, CA 95762 | 2017-12-05 |
| 1275063000 | Melinda Diane Keeler | Marriage & Family Therapist | 1150 Sunfast Lane, 2, El Dorado Hills, CA 95762 | 2017-06-14 |
| 1205379021 | Lauren Marie Shanks Rigsbee | Physical Therapist | 4990 Hillsdale Circle # 100, El Dorado Hills, CA 95762 | 2016-11-28 |
| 1962825935 | Wendy Pickren | Psychologist | 1150 Suncast Lane, Suite 2, El Dorado Hills, CA 95762 | 2014-01-28 |
| 1588087597 | Edwards Everhart Dental | Dentist | 1192 Suncast Lane, Suite 3, El Dorado Hills, CA 95762 | 2014-01-27 |
| 1447694542 | Ksenia Voronina | Psychiatry & Neurology | 1020 Suncast Lane, St 108, El Dorado Hills, CA 95762 | 2013-04-19 |
| 1205188471 | Pirasteh Guity Shafe | Pediatrics | 5001 Gresham Dr, El Dorado Hills, CA 95762 | 2012-10-11 |
| Find all providers in zip 95762 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902260334 | Nelly Aghili | Nurse Practitioner | 473 Torero Way, El Dorado Hills, CA 95762-3539 | 2016-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619442 | Dolores Josephine Meehan | Nurse Practitioner | South Bay Vascular Center, 2255 South Bascom Avenue Suite 200, Campbell, CA 95008-7800 | 2020-11-03 |
| 1013517960 | Kristina Pulliam Markey | Nurse Practitioner | 11234 Anderson Strreet, Loma Linda, CA 92354 | 2020-10-29 |
| 1851990550 | Fernanda Monteon Ibarra | Nurse Practitioner | 30222 Belmont Ct, Agoura Hills, CA 91301-4611 | 2020-10-22 |
| 1780283168 | Brenda Rienru Rhima | Nurse Practitioner | 24657 Rockston Dr, Corona, CA 92883-1614 | 2020-10-18 |
| 1215535034 | Shiji John | Nurse Practitioner | 3765 Gunnison Cir, Corona, CA 92881-8486 | 2020-10-14 |
| 1053919258 | Lacey Etienne Neufeld | Nurse Practitioner | Marshall Transitional Care Unit, 1100 Marshall Way, Placerville, CA 95667 | 2020-10-12 |
| 1063028298 | Kanokwan Kultan | Nurse Practitioner | 15850 Babcock St, San Diego, CA 92127-3680 | 2020-09-22 |
| 1538775093 | David Lee | Nurse Practitioner | 5710 S Glennie Ln Apt A, Los Angeles, CA 90016-1063 | 2020-09-21 |
| 1124634886 | Catherine Kestenian | Nurse Practitioner | 351 E Foothill Blvd Ste 250, Arcadia, CA 91006-7426 | 2020-09-18 |
| 1285249565 | Anu Tharoor | Nurse Practitioner | 505 Parnassus Ave Fl 9, San Francisco, CA 94143-2204 | 2020-09-13 |
| Find all providers with the same taxonomy | ||||
| City | EL DORADO HILLS |
| Zip Code | 95762 |
Please comment or provide details below to improve the information on DEIRDRE ALICE MAZZETTO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.