Maria Fatima Georgia Fernandez Misa

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

95004318 Issued in CA

Practice address

5722 Monte Vista St
Los Angeles, CA 90042-3428

Phone

(714) 473-4051

NPI assigned

Dec 14, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Maria Fatima Georgia Misa Thieme Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1481673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524700800000",
    "number": "1013451731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5722 MONTE VISTA ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900423428",
            "telephone_number": "714-473-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5722 MONTE VISTA ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900423428",
            "telephone_number": "714-473-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISA",
        "first_name": "MARIA FATIMA GEORGIA",
        "middle_name": "FERNANDEZ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-14",
        "last_updated": "2018-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95004318",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95004318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA FATIMA GEORGIA",
            "last_name": "THIEME",
            "middle_name": "MISA",
            "prefix": "MRS.",
            "credential": "NP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Armen Mirzayan
• Araxi Mirzoyan Kalach, DMD
• Diana Mirzoyan, M.D.
• Gor Mirzoyan, DO
• Augustine-John Misa
• Misak H. Abdulian, M.D., Inc
• Melinda Akemi Misaki
• Misali Med. GR. Inc.
• Paul Mischel, MD
• Jennifer Mischer, PSYD

• Primary Care Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; 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.