TIMOTHY WAYNE MANSOURI (NPI# 1770970899) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770970899 |
| Entity Type | Individual |
| Full Name | TIMOTHY WAYNE MANSOURI |
| Other Name | TIM MANSOURI |
| Credential | NURSE PRACTITIONER |
| Practice Address |
1600 Creekside Dr Ste 2400 Folsom CA 95630-3485 |
| Mailing Address |
8732 Flute Cir Elk Grove CA 95757-1742 |
| Practice Telephone | 9169324163 |
| Mailing Telephone | 2097658297 |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2020-03-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0000X |
Registered Nurse Specialization: Pain Management |
656576 | CA | Nursing Service Providers |
| Y | 163WP0000X |
Registered Nurse Specialization: Pain Management |
95003073 | CA | Nursing Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1665 Creekside Dr Ste 100, Folsom, CA 956303538 | 9169324163 |
| Street Address |
1600 CREEKSIDE DR STE 2400 |
| City | FOLSOM |
| State | CA |
| Zip Code | 95630-3485 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407277155 | Bingtao Lin | Physical Medicine & Rehabilitation | 1600 Creekside Dr Ste 2400, Folsom, CA 95630-3485 | 2013-12-25 |
| 1750865358 | Bingtao Lin, Md, PC | Physical Medicine & Rehabilitation | 1600 Creekside Dr Ste 2400, Folsom, CA 95630-3485 | 2018-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831724657 | Corrections and Rehabilitation | Pharmacy | 570 E. Natoma Street, Folsom, CA 95630 | 2020-03-12 |
| 1174153027 | Haley Harmon | Nurse Practitioner | 1621 Creekside Dr. Creekside Ob/gyn, Ste. 102, Folsom, CA 95630 | 2020-01-20 |
| 1932741469 | Ruma Ramani Jolly | Speech-Language Pathologist | 250 Mc Adoo Drive, Willow Springs, Apt.911, Folsom, CA 95630 | 2019-10-16 |
| 1750844767 | Sharon Munyaanyi | Registered Nurse | 1600 Creekside Dr Ste 3700, Folsom, CA 95630 | 2019-04-08 |
| 1104308345 | Stephanie Whatley | Optometrist | 2390 E Bidwell St Ste 400, Folsom, CA 95630 | 2018-09-04 |
| 1447746607 | Heather Michellee Thrapp | Behavioral Analyst | 125 Oak Ravine Way, Folsom, CA 95630 | 2018-07-10 |
| 1700370483 | Loretta May Delgado | Behavior Technician | 322 Crow Cany, Folsom, CA 95630 | 2018-06-18 |
| 1417448176 | Sound Support Inc. | Hearing Instrument Specialist | 610 East Bidwell Street, Suite A, Folsom, CA 95630 | 2018-05-29 |
| 1548750144 | Don Peterson Md, Sugical Assisting | General Practice | Mercy Hospital of Folsom (dignity Health Folsom), 1650 Creekside Dr., Folsom, CA 95630 | 2018-05-18 |
| 1245733328 | American Heritage Hospice Inc | Hospice Care, Community Based | 1837 Iron Point Rd Ste 180, Folsom, CA 95630 | 2018-03-14 |
| Find all providers in zip 95630 | ||||
| Taxonomy Code | 163WP0000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Pain Management |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124659685 | Fiji Simmons | Registered Nurse | 16379 E Preserve Loop Unit 2009, Chino, CA 91708-9400 | 2020-02-03 |
| 1396210605 | Nicole Joy Davis | Registered Nurse | 2970 Pawnee Ct, Redding, CA 96001-3482 | 2018-10-12 |
| 1558725994 | Skye Spine & Pain Medical Group, Inc | Registered Nurse | 1314 W Avenue J Ste A, Lancaster, CA 93534-2936 | 2016-04-12 |
| 1164896957 | Mobile Palliative Care, Inc. | Registered Nurse | 18302 Sierra Hwy Ste 103, Canyon Country, CA 91351-6126 | 2015-11-17 |
| 1821481706 | Tara Jeffery | Registered Nurse | 512 N Blanche St, Ojai, CA 93023-2517 | 2015-03-16 |
| 1689971863 | Constance Louise Borden | Registered Nurse | 426 Day St, San Francisco, CA 94131-2229 | 2011-02-23 |
| 1184643579 | Catherine R Copeland | Registered Nurse | 485 Antelope Blvd Ste G, Red Bluff, CA 96080-2444 | 2006-07-18 |
| 1174908206 | Janet Elaine Conley | Registered Nurse | 39000 Bob Hope Drive, Harry & Diane Rinker Building, Rancho Mirage, CA 92270 | 2015-07-30 |
| 1316287436 | Karen Lane | Registered Nurse | 4305 Gesner St Ste 101, San Diego, CA 92117-6673 | 2013-02-26 |
| 1740506575 | Julie Mallory | Registered Nurse | 1524 Mchenry Ave Ste 470, Modesto, CA 95350-4572 | 2010-04-19 |
| Find all providers with the same taxonomy | ||||
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| 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.