Pamela Sue Baldivia, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95003979 Issued in CA

Practice address

757 Westwood PLZ
Suite B790A
Los Angeles, CA 90095-7404

Phone

(310) 267-3894

Fax

(310) 267-3894

NPI assigned

Apr 26, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Pamela Sue Cruz Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• UC Regents

  • Pediatrics Physician
  • Los Angeles, CA
  • NPI 1982667663
  Medicare reassignment NPD

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1033564109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ",
            "address_2": "SUITE B790A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900957404",
            "telephone_number": "310-267-3894",
            "fax_number": "310-267-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDIVIA",
        "first_name": "PAMELA SUE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-26",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA SUE",
            "last_name": "CRUZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jonathan Balderrama
• Melissa Balderrama, PHD
• Cheryl Baldinger, B.A., M.A.
• Vanessa Dyana Baldini, MFT
• Ana Baldioli, PT
• Fatima Carmen Baldizon
• Savannah Baldonado
• Bryant Baldorado
• Derek James Baldridge, LCSW
• Baldwin Hills Crenshaw Urgent Care

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.