Individual provider Active NPI

Farah Jama, REGISTERED NURSE

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1043859978
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95025394 Issued in CA
Practice address
3851 Rosecrans St
San Diego, CA 92110-3115
Phone
(858) 717-1075
NPI assigned
Dec 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95025394 CA Primary

Addresses

Primary practice location

3851 Rosecrans St
San Diego, CA 92110-3115

Mailing address

3806 Fairmount Ave Apt 235
San Diego, CA 92105-7601
Phone (858) 717-1075

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240425001376 CA Practitioner - Nurse Practitioner 2466892369 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Health Plan of California, Inc. CurrentSince Mar 18, 2024 Accepting new patients
La Maestra Family Clinic, Inc. CurrentSince May 19, 2024 Accepting new patients
Molina Healthcare of California CurrentSince Mar 18, 2024 Accepting new patients
La Maestra Family Clinic, Inc. CurrentSince May 19, 2024 Accepting new patients
Universal Care CurrentSince Mar 18, 2024 Accepting new patients
La Maestra Family Clinic, Inc. Current Accepting new patients

Locations

165 S 1st St
El Cajon, CA 92019
Phone (619) 312-0347

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

4060 Fairmount Ave
San Diego, CA 92105
Phone (619) 255-9155

4074 Fairmount Ave
San Diego, CA 92105
Phone (619) 284-1141

Interoperability endpoints

  • Direct secure messaging: farah.jama.p1@direct.lamaestra.nextgenshare.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1577059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1043859978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3806 FAIRMOUNT AVE APT 235",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921057601",
            "telephone_number": "858-717-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 ROSECRANS ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103115",
            "telephone_number": "858-717-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMA",
        "first_name": "FARAH",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-23",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95025394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.