DIANA APRIL MUCKLER APNP, PMHNP-BC
Complete NPI Record 1184279739
Nurse Practitioner - Psychiatric/Mental Health in Folsom, CA
Active since August 09, 2019PECOS Enrolled
Complete NPI Dataset
This page contains the complete raw NPPES record for Diana April Muckler, APNP, PMHNP-BC (NPI 1184279739), an individual nurse practitioner provider in Folsom, CA. All 43 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
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Registry File Document Utilities
- NPI: 1184279739 Field 1/43
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1 Field 2/43
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: MUCKLER Field 3/43
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: DIANA APRIL Field 4/43
- The first name of the provider, if the provider is an individual.
- Provider Credential Text: APNP, PMHNP-BC Field 5/43
- The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
- Provider First Line Business Mailing Address: 510 PLAZA DR STE 170 Field 6/43
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: FOLSOM Field 7/43
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: CA Field 8/43
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 956304790 Field 9/43
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 10/43
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 9163519400 Field 11/43
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 9163519449 Field 12/43
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 510 PLAZA DR STE 170 Field 13/43
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: FOLSOM Field 14/43
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: CA Field 15/43
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 956304790 Field 16/43
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 17/43
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 9163519400 Field 18/43
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 9163519449 Field 19/43
- The fax number associated with the location address of the provider being identified.
- Provider Gender Code: F Field 22/43
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 163W00000X Field 23/43
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: 816285 Field 24/43
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: CA Field 25/43
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: N Field 26/43
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 2: 363LP0808X Field 27/43
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 2: NP95028669 Field 28/43
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 2: CA Field 29/43
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 2: Y Field 30/43
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 3: 163W00000X Field 31/43
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 3: 189932-30 Field 32/43
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 3: WI Field 33/43
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 3: N Field 34/43
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 4: 363LP0808X Field 35/43
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 4: 9428-33 Field 36/43
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 4: WI Field 37/43
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 4: N Field 38/43
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: 1083728612 Field 39/43
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 05 Field 40/43
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: WI Field 41/43
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Is Sole Proprietor: N Field 42/43
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
Secondary Practice Locations 33
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
1372 N Main St Ste 206-1
Location 1/33Walnut Creek, CA 94596-4692 · Phone (916) 351-9400
1501 W Cameron Ave Ste 300-129
Location 2/33West Covina, CA 91790-2724 · Phone (916) 351-9400
7365 Carnelian St Ste 222F
Location 3/33Rancho Cucamonga, CA 91730-1157 · Phone (916) 351-9400
1101 Maidu Dr
Location 4/33Auburn, CA 95603-5864 · Phone (916) 351-9400
9381 E Stockton Blvd Ste 220
Location 5/33Elk Grove, CA 95624-5070 · Phone (916) 351-9400
2440 Professional Dr
Location 6/33Roseville, CA 95661-7773 · Phone (916) 351-9400
1245 W 6th St
Location 7/33Corona, CA 92882-1870 · Phone (916) 351-9400
44240 Fremont Blvd
Location 8/33Fremont, CA 94538-6000 · Phone (916) 351-9400
622 Jackson St Unit 103
Location 9/33Fairfield, CA 94533-6195 · Phone (916) 351-9400
169 Hartnell Ave Ste 110
Location 10/33Redding, CA 96002-1849 · Phone (916) 351-9400 · Fax (916) 351-9449
1254 Mission St Ste 220
Location 11/33San Francisco, CA 94103-2706 · Phone (916) 351-9400
2386 Fair Oaks Blvd
Location 12/33Sacramento, CA 95825-4741 · Phone (916) 351-9400
15720 Ventura Blvd Ste 210
Location 13/33Encino, CA 91436-2954 · Phone (916) 351-9400
1825 N Oxnard Blvd Ste 19
Location 14/33Oxnard, CA 93030-3503 · Phone (916) 351-9400 · Fax (916) 351-9449
355 W Olive Ave Ste 3
Location 15/33El Centro, CA 92243-3043 · Phone (916) 351-9400 · Fax (916) 351-9449
55 Hitchcock Way Ste 209
Location 16/33Santa Barbara, CA 93105-5635 · Phone (916) 351-9400 · Fax (916) 351-9449
5441 Aldrin Ct Ste A
Location 17/33Bakersfield, CA 93313-2194 · Phone (916) 351-9400
4025 N Fresno St
Location 18/33Fresno, CA 93726-4026 · Phone (916) 351-9400
2955 Main St Ste 110-K
Location 19/33Irvine, CA 92614-5909 · Phone (916) 351-9400
2008 W Dorothea Ave Ste 203
Location 20/33Visalia, CA 93277-7300 · Phone (916) 351-9400 · Fax (916) 351-9449
509 13th St Ste 8
Location 21/33Modesto, CA 95354-2444 · Phone (916) 351-9400
2222 Pacific Ave
Location 22/33Stockton, CA 95204-5334 · Phone (916) 351-9400
7177 Brockton Ave Ste 444A
Location 23/33Riverside, CA 92506-2635 · Phone (916) 351-9400
2345 Fletcher Pkwy
Location 24/33El Cajon, CA 92020-2134 · Phone (916) 351-9400
888 4th St Ste 12
Location 25/33San Rafael, CA 94901-3284 · Phone (916) 351-9400
225 W Hospitality Ln # 225201P
Location 26/33San Bernardino, CA 92408-3237 · Phone (916) 351-9400
1040 Park Ave Ste 200-A
Location 27/33San Jose, CA 95126-3075 · Phone (916) 351-9400
3200 4th Ave Ste 200G
Location 28/33San Diego, CA 92103-5716 · Phone (916) 351-9400
2062 Talbert Dr Ste 100
Location 29/33Chico, CA 95928-7718 · Phone (916) 351-9400
3711 Long Beach Blvd Ste 4045
Location 30/33Long Beach, CA 90807-3320 · Phone (916) 351-9400 · Fax (916) 351-9449
414 W 21st St
Location 31/33Merced, CA 95340-3718 · Phone (916) 351-9400 · Fax (916) 351-9449
30 E San Joaquin St Ste 203B
Location 32/33Salinas, CA 93901-2947 · Phone (916) 351-9400 · Fax (916) 351-9449
634 H St
Location 33/33Eureka, CA 95501-1053 · Phone (916) 351-9400 · Fax (916) 351-9449
Other Provider Identifiers 1
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
1083728612 Medicaid
Identifier 1/1State: WI
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
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