Active NPI
Barbara Lynn Niklas, MSN, CPNP
- Pediatric Nurse Practitioner
- Brea, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- RN318310
- Practice address
- 955 W Imperial Hwy Ste 200
Brea, CA 92821-3812 - Phone
- (714) 671-0766
- NPI assigned
- Feb 23, 2007
- Last updated
- Nov 9, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | RN318310 | CA | Primary |
Addresses
Primary practice location
955 W Imperial Hwy Ste 200
Brea, CA 92821-3812
Mailing address
2410 Redcoach LN
La Habra, CA 90631-6254
Phone (562) 694-3694
Other practice location 1
2720 N Harbor Blvd
Suite 300
Fullerton, CA 92835-2609
Phone (714) 449-6990
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bniklas1374312@oc.providencedirect.org |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN318310 | CA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Foundation | Current | Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients | |
| St Jude Hospital Inc | Past | Accepting new patients | |
| Providence Medical Foundation | Past | Accepting new patients |
Locations
200 W Ctr St Promenade
Ste 400
Anaheim, CA 92805
955 W Imperial Hwy
Ste 200
Brea, CA 92821
Phone (714) 449-6900
100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200
1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835
2720 N Harbor Blvd
Ste 300
Fullerton, CA 92835
Phone (657) 632-0123
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Brea, CA
- NPI 1871607762
-
- General Practice Physician
- Diamond Bar, CA
- NPI 1285890624
-
- Family Medicine Physician
- Anaheim, CA
- NPI 1639715709
-
dba Providence St. Jude Medical Center
- General Acute Care Hospital
- Fullerton, CA
- NPI 1194926279
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636416000000",
"number": "1053446617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2410 REDCOACH LN",
"city": "LA HABRA",
"state": "CA",
"postal_code": "906316254",
"telephone_number": "562-694-3694",
"fax_number": "714-449-6971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "955 W IMPERIAL HWY STE 200",
"city": "BREA",
"state": "CA",
"postal_code": "928213812",
"telephone_number": "714-671-0766"
}
],
"practiceLocations": [
{
"address_1": "2720 N Harbor Blvd",
"address_2": "Suite 300",
"address_purpose": "LOCATION",
"city": "Fullerton",
"state": "CA",
"postal_code": "928352609",
"country_code": "US",
"telephone_number": "714-449-6990",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NIKLAS",
"first_name": "BARBARA",
"middle_name": "LYNN",
"credential": "MSN, CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-23",
"last_updated": "2021-11-09",
"certification_date": "2021-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CA",
"license": "RN318310",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "bniklas1374312@oc.providencedirect.org",
"affiliation": "N",
"address_1": "955 W Imperial Hwy Ste 200",
"city": "Brea",
"state": "CA",
"country_code": "US",
"postal_code": "928213812",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Brea, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.