Individual provider Active NPI

Starly Alvarado, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Gardena, CA
National Provider Identifier
1003444597
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95013839 Issued in CA
Practice address
1045 W Redondo Beach Blvd Ste 300
Gardena, CA 90247-4175
Phone
(323) 241-6730
NPI assigned
Mar 30, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95013839 CA Primary

Addresses

Primary practice location

1045 W Redondo Beach Blvd Ste 300
Gardena, CA 90247-4175

Mailing address

1045 W Redondo Beach Blvd Ste 300
Gardena, CA 90247-4175
Phone (323) 241-6730

Other identifiers 1

IdentifierTypeStateIssuer
95013839OtherCABOARD OF REGISTERED NURSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210223000919 CA Practitioner - Nurse Practitioner 5496160533 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Los Angeles County Department of Mental HealthGroup PAC ID 7416869896, 294 clinicians

Practice addresses (Care Compare)

1045 W Redondo Beach Blvd
Gardena, CA 90247-4128
Phone (323) 241-6730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95013839CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Current Accepting new patients
Eagan Medical Group, Inc. CurrentSince Feb 16, 2021 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jul 22, 2023 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jul 22, 2023 Accepting new patients

Locations

1901 Newport Blvd
Ste 280
Costa Mesa, CA 92627
Phone (281) 210-6703

1045 W Redondo Beach Blvd
Ste 300
Gardena, CA 90247
Phone (310) 352-4170

1045 W Redondo Beach Blvd
Gardena, CA 90247
Phone (310) 329-1444

10515 Balboa Blvd
Granada Hills, CA 91344
Phone (818) 486-3837

2311 W El Segundo Blvd
Hawthorne, CA 90250
Phone (310) 241-6730

7677 Center Ave
Ste 405
Huntington Beach, CA 92647
Phone (714) 369-8037

18401 Von Karman Ave
Ste 500
Irvine, CA 92612
Phone (305) 343-5995

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1003444597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 W REDONDO BEACH BLVD STE 300",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474175",
            "telephone_number": "323-241-6730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 W REDONDO BEACH BLVD STE 300",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474175",
            "telephone_number": "323-241-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVARADO",
        "first_name": "STARLY",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-30",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95013839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF REGISTERED NURSING",
            "identifier": "95013839",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.