Individual provider Active NPI

Marianne Rivera Lucila, RN

  • Family Nurse Practitioner
  • Santa Clarita, CA
National Provider Identifier
1023647765
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95015652 Issued in CA
Practice address
19614 Aldbury St
Santa Clarita, CA 91351-1103
Phone
(213) 590-7611
NPI assigned
Apr 4, 2020
Last updated
Aug 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95015652 CA Primary
Medical-Surgical Registered Nurse 163WM0705X 649777 CA

Addresses

Primary practice location

19614 Aldbury St
Santa Clarita, CA 91351-1103

Mailing address

19614 Aldbury St
Santa Clarita, CA 91351-1103
Phone (213) 590-7611

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)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1585958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1023647765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19614 ALDBURY ST",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913511103",
            "telephone_number": "213-590-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19614 ALDBURY ST",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913511103",
            "telephone_number": "213-590-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCILA",
        "first_name": "MARIANNE",
        "middle_name": "RIVERA",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-04",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95015652",
            "primary": true
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "CA",
            "license": "649777",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clarita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; 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.