MR. MICHAEL VINCENT LIBERATO (NPI# 1962674465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962674465 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL VINCENT LIBERATO |
| Credential | PA-C |
| Practice Address |
201 29th St Suite B Sacramento CA 95816-3271 |
| Mailing Address |
1691 The Alameda San Jose CA 95126-2203 |
| Practice Telephone | 9164466921 |
| Practice Fax Number | 9164460640 |
| Mailing Telephone | 4082877532 |
| Mailing Fax Number | 4082870405 |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2012-05-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA19657 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE PTAN | GA202Z | 01 |
| Street Address |
201 29TH ST SUITE B |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95816-3271 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679526693 | Planned Parenthood Mar Monte, Inc | Clinic/Center | 201 29th St, Suite B, Sacramento, CA 95816-3271 | 2006-05-19 |
| 1215213400 | Rachel Schachere Mcmichael | Nurse Practitioner | 201 29th St, Ste B, Sacramento, CA 95816-3288 | 2011-11-01 |
| 1477869873 | Mary Ann Gholson | Physician Assistant | 201 29th St, Suite B, Sacramento, CA 95816-3288 | 2010-08-23 |
| 1063674406 | Lisa Lyn Bayani | Nurse Practitioner | 201 29th St, Ste B, Sacramento, CA 95816-3271 | 2008-06-26 |
| 1548300254 | Janet Susan Poarch-nugent | Registered Nurse | 201 29th St, Suite A, Sacramento, CA 95816-3271 | 2007-02-08 |
| 1548336688 | Karen M. Webster | Family Medicine | 201 29th St, Suite B, Sacramento, CA 95816-3271 | 2006-11-28 |
| 1487723698 | Letitia Dianne Estes | Registered Nurse | 201 29th St, Suite B, Sacramento, CA 95816-3271 | 2006-11-06 |
| 1912097064 | Donna Gale Smith | Nurse Practitioner | 201 29th St, Suite B, Sacramento, CA 95816-3271 | 2006-10-12 |
| 1164533451 | Mary D Kertes | Advanced Practice Midwife | 201 29th St, Suite B, Sacramento, CA 95816-3271 | 2006-08-31 |
| 1477667962 | Ronald Berman | Obstetrics & Gynecology | 201 29th St, Suite B, Sacramento, CA 95816-3271 | 2006-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922618917 | Alyssa Weakley | Clinical Neuropsychologist | Uc Davis Midtown Neurology Clinic, 3160 Folsom Blvd, Sacramento, CA 95816 | 2020-08-04 |
| 1417418955 | Soraya Foutouhi | Student in an Organized Health Care Education/Training Program | 301 C Street, Suite 1400, Sacramento, CA 95816 | 2019-03-27 |
| 1265902704 | Daljit Girn | Behavior Technician | 1315 Alhambra Blvd Ste 110, Sacramento, CA 95816 | 2018-11-27 |
| 1609385178 | Jared James Harold-husted | Behavior Technician | 3031 C St, Sacramento, Sacramento, CA 95816 | 2017-09-27 |
| 1124537170 | Phuong Huynh | Behavior Technician | 3009 C Street, Sacramento, CA 95816 | 2017-09-21 |
| 1427570811 | Manpreet Kaur Chehal | Counselor | 500 22nd Street, Sacramento, CA 95816 | 2017-07-07 |
| 1295264646 | Veronica Lynn Just | Behavior Technician | 3031 C St., Sacramento, CA 95816 | 2017-06-08 |
| 1285163907 | Marquise Jones | Behavior Technician | 3031 C Street, Sacramento, CA 95816 | 2017-06-06 |
| 1578007159 | Kate Hanel | Student in an Organized Health Care Education/Training Program | 2500 I St, Sacramento, CA 95816 | 2016-12-15 |
| 1184174534 | Jennifer M Stegner | Nurse Practitioner | 1625 Stockton Blvd #104, Sacramento, CA 95816 | 2016-10-10 |
| Find all providers in zip 95816 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689271587 | Vera Pavlovna Kondrashov | Physician Assistant | 1860 Howe Ave Ste 455, Sacramento, CA 95825-1086 | 2020-10-04 |
| 1861017691 | Kathryn Anne Pashalides | Physician Assistant | 1400 57th St, Sacramento, CA 95819-4205 | 2020-06-08 |
| 1396369567 | Isabelle Shapiro | Physician Assistant | 1411 U St, Sacramento, CA 95818-1416 | 2020-06-03 |
| 1487276382 | Ndaya Briana Kalambay | Physician Assistant | 3910 Auburn Blvd Apt 68, Sacramento, CA 95821-2130 | 2020-05-13 |
| 1053942888 | Eduardo Sevilla | Physician Assistant | 8129 Polo Crosse Ave, Sacramento, CA 95829-6546 | 2020-01-30 |
| 1316582695 | Lauren Hunter | Physician Assistant | 6600 Bruceville Rd Rm 1h5, Sacramento, CA 95823-4671 | 2019-11-11 |
| 1942841176 | Kimia Ighani | Physician Assistant | 3429 2nd Ave, Sacramento, CA 95817-2802 | 2019-09-29 |
| 1386290195 | Anthony Menacho | Physician Assistant | 2472 Larkspur Ln Apt 363, Sacramento, CA 95825-4153 | 2019-08-16 |
| 1891341178 | Ebtesam Gerges | Physician Assistant | 4411 4th Ave Apt B, Sacramento, CA 95817-3059 | 2019-08-13 |
| 1295392488 | Shea L Smith | Physician Assistant | 2570 48th St, Sacramento, CA 95817-1541 | 2019-05-22 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95816 |
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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.