Individual provider Active NPI

Victoria Susan Chidboy, RN

  • Critical Care Medicine Registered Nurse
  • Pomona, CA
National Provider Identifier
1023534104
Registry record updated Aug 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
95099204 Issued in CA
Practice address
1798 N Garey Ave
Pomona, CA 91767-2918
Phone
(909) 865-9500
NPI assigned
Aug 20, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WC0200X 95099204 CA Primary

Addresses

Primary practice location

1798 N Garey Ave
Pomona, CA 91767-2918

Mailing address

1009 Guinea Dr
Whittier, CA 90601-1224
Phone (626) 428-1511

Other identifiers 1

IdentifierTypeStateIssuer
XELT50473968OtherCABLUE OF CALIFORNIA

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
95099204CAMDCritical Care Medicine Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1503187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503187200000",
    "number": "1023534104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 GUINEA DR",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906011224",
            "telephone_number": "626-428-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1798 N GAREY AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672918",
            "telephone_number": "909-865-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIDBOY",
        "first_name": "VICTORIA",
        "middle_name": "SUSAN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-20",
        "last_updated": "2017-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "95099204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE OF CALIFORNIA",
            "identifier": "XELT50473968",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2017; 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.