Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nicholas J Theobald, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1205102522

Nicholas J Theobald, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Sacramento, California. Qualified in 2009, 17 years ago. Practices with Banner Lassen Medical Center, a 5-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
17
Licensed in
CA
In the registry since
2012
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

6600 Bruceville Rd
Sacramento, CA 95823-4671
Phone: (916) 688-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 4155 (CA)

Record details

NPI number1205102522
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedMarch 30, 2012
Last updated in NPPESMarch 30, 2012

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Banner Lassen Medical Center — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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