Active Life Wound Clinic A Professional Nursing Corporation
NPI 1801253323ActiveOrganization· Nurse Practitioner· Sacramento, CA
Nurse Practitioner in Sacramento, California, registered in NPPES in January 2016. The authorized official on file is Jeff Souza, President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1801253323 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 28, 2016 |
| Last updated in NPPES | Apr 15, 2025 |
| Certified by provider | Apr 15, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | — | — |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CA) |
|---|
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