Timothy Wayne Mansouri, NURSEPRACTITIONER
Timothy Wayne Mansouri, NURSEPRACTITIONER is a Nurse Practitioner in Folsom, California. Qualified in 2015, 11 years ago. Practices with Advanced Pain Diagnostic and Solutions Inc, a 20-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.
- Years since qualifying
- 11
- Licensed in
- CA
- In the registry since
- 2015
- Specialties on file
- 2
Practice location Address checks out
1600 Creekside Dr Ste 2400Folsom, CA 95630-3485
Phone: (916) 932-4163
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Additional practice locations (1)
- 1665 Creekside Dr Ste 100, Folsom, CA 95630-3538 — (916) 932-4163
Specialties & licences
| Pain Management Registered Nurse (primary) | Taxonomy 163WP0000X · Licence 95003073 (CA) |
|---|---|
| Pain Management Registered Nurse | Taxonomy 163WP0000X · Licence 656576 (CA) |
Record details
| NPI number | 1770970899 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | NURSEPRACTITIONER |
| Sole proprietor | Yes |
| NPI enumerated | April 16, 2015 |
| Last updated in NPPES | March 3, 2020 |
| Certification date | March 3, 2020 |
| Mailing address | 8732 Flute Cir, Elk Grove, CA 95757-1742 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2015 (11 years in practice) |
| Group practice | Advanced Pain Diagnostic And Solutions Inc — 20 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |