Ida R Fields
Individual provider Active NPI Homemaker · Apple Valley, CA
NPI 1033980941 · NPPES record last updated Jan 10, 2024
Key facts
- NPI
- 1033980941
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Homemaker 376J00000X
- License
- E31922210 (CA)
- Practice address
- 22131 Miramot Rd
Apple Valley, CA 92308-7394 - Phone
- (760) 217-5187
- NPI assigned
- Jan 10, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E31922210 | CA | MD | Homemaker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | E31922210 | CA | Yes |
Addresses
Primary practice location
22131 Miramot Rd
Apple Valley, CA 92308-7394
Mailing address
22131 Miramot Rd
Apple Valley, CA 92308-7394
Other practice location 1
22131 Miramot Rd
Apple Valley, CA 92308-7394
Phone (760) 217-5187
Other providers in Apple Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.