# RANDY V. MALLARI

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1306198429
- **Gender:** Man
- **Credential:** PMHNP-BC/C, FNP-BC/C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LF0000X | Family Nurse Practitioner | 95034292 | CA | — |
| 363LF0000X | Family Nurse Practitioner | APRN-5050 | HI | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 10041249 | OR | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 321587 | AZ | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 83016 | NM | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 873430 | NV | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 95034292 | CA | — |

## Other

- **Enumeration date:** 10/12/2012
- **Last updated:** 07/25/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 096781 | — | AZ |