NPI age
4 years
Enumerated 2022-04-21
● Active
Type 1 · Individual
Penny Angel Mata, MEDICAL ASSISTANT
Mata is 1 of 1 specialist/technologist providers in Caldwell and 1 of 4 in Idaho.
Primary specialty
Specialist/Technologist
Licensed in
—
0 states
Status
Active
No deactivations on record
Last NPPES update
2022-04-21
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 4 active specialist/technologist providers in Idaho.
NPI age
4 years
↓ 2 yr below median (6 yr)
State licenses
1 state
0% of peers hold multiple states
Subspecialties
0
0% of peers hold subspecialties
NPI lifetime · 2022 → 2026
2022-04Enumerated in NPPES
2022
2026
Where they practice
Practice location
4521 Thomas Jefferson St
Caldwell, ID 836055100
Mailing address
4521 Thomas Jefferson St
Caldwell, ID 836055100
Specialties
-
Specialist/Technologist PrimaryGeneral classification identifying individuals who are trained on a specific piece of equipment or technical procedure.
Practice context
Part of a multi-provider practice. 28 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
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