Individual provider Active NPI

Larissa Todd

  • Family Nurse Practitioner
  • Aliso Viejo, CA
National Provider Identifier
1013360106
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP 95004416 Issued in CA
Practice address
26891 Aliso Creek Rd
Aliso Viejo, CA 92656-3392
Phone
(949) 360-4081
NPI assigned
Jul 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP 95004416 CA Primary

Addresses

Primary practice location

26891 Aliso Creek Rd
Aliso Viejo, CA 92656-3392

Mailing address

File 50670
Los Angeles, CA 90074-0670
Phone (888) 227-3312

Other practice location 1

26800 Crown Valley Pkwy Ste 315
Mission Viejo, CA 92691-8039
Phone (949) 364-6000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ltodd1524596@oc.providencedirect.org

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
I20160817001902 CA Practitioner - Nurse Practitioner 5799070660 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP 95004416CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation CurrentSince Feb 28, 2021 Accepting new patients
American Current Care, PA Current Accepting new patients
Providence Facey Medical Foundation CurrentSince Feb 28, 2021 Accepting new patients
Providence Facey Medical Foundation Current Accepting new patients
Telehealth Services USA Past Accepting new patients

Locations

25612 Crown Valley Pkwy
Ste L-5
Ladera Ranch, CA 92694
Phone (818) 847-6812

File 50670
Los Angeles, CA 90074

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

4015 Jefferson Hwy
New Orleans, LA 70121
Phone (504) 837-6447

Organizations & group practices 5

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": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1013360106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 50670",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900740670",
            "telephone_number": "888-227-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26891 ALISO CREEK RD",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926563392",
            "telephone_number": "949-360-4081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26800 Crown Valley Pkwy Ste 315",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "926918039",
            "country_code": "US",
            "telephone_number": "949-364-6000",
            "fax_number": "949-364-1204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TODD",
        "first_name": "LARISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-13",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP 95004416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ltodd1524596@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "25612 Crown Valley Pkwy Ste L-5",
            "city": "Ladera Ranch",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926940476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Aliso Viejo, CA

Sources for this page

Verify at the official NPI Registry.