Individual provider Active NPI

Candice Marie Palmisano, CNS

  • Clinical Nurse Specialist
  • Los Angeles, CA
National Provider Identifier
1003442591
Registry record updated Mar 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
4734 Issued in CA
Practice address
2051 Marengo St
Los Angeles, CA 90033-1352
Phone
(323) 409-8559
NPI assigned
Mar 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X 4734 CA Primary

Addresses

Primary practice location

2051 Marengo St
Los Angeles, CA 90033-1352

Mailing address

1319 Carroll Ave
Los Angeles, CA 90026-5109
Phone (323) 428-6210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
4734CAMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1584403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1003442591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 CARROLL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900265109",
            "telephone_number": "323-428-6210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 MARENGO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331352",
            "telephone_number": "323-409-8559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMISANO",
        "first_name": "CANDICE",
        "middle_name": "MARIE",
        "credential": "CNS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-17",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "CA",
            "license": "4734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.