Individual provider Active NPI

Liliana P. Prakasam, F.N.P.

  • Family Nurse Practitioner
  • Salinas, CA
National Provider Identifier
1053493734
Registry record updated Dec 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
13959 Issued in CA
Practice address
219 N Sanborn Rd
Salinas, CA 93905-2218
Phone
(831) 757-1365
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 569971 CA
Family Nurse Practitioner 363LF0000X 13959 CA Primary

Addresses

Primary practice location

219 N Sanborn Rd
Salinas, CA 93905-2218

Mailing address

219 N Sanborn Rd
Salinas, CA 93905-2218
Phone (831) 757-1365

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150729009027 CA Practitioner - Physician Assistant 1759695166 Reassigns benefits to 1 organization
I20181207000244 CA Practitioner - Nurse Practitioner 1759695166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1151 E Walnut St
Ontario, CA 91761-6155
Phone (909) 467-1425

308 N la Cadena Dr
Colton, CA 92324-2946
Phone (909) 321-0700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
569971CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Unicare Community Health Center Inc Current Accepting new patients
Unicare Community Health Center, Inc. CurrentSince Sep 15, 2018 Accepting new patients

Locations

308 N La Cadena Dr
Colton, CA 92324
Phone (909) 321-4700

437 N Euclid Ave
Ontario, CA 91762
Phone (909) 749-1835

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325030400000",
    "number": "1053493734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 N SANBORN RD",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939052218",
            "telephone_number": "831-757-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 N SANBORN RD",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939052218",
            "telephone_number": "831-757-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRAKASAM",
        "first_name": "LILIANA",
        "middle_name": "P.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2011-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "569971",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "13959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salinas, CA

Sources for this page

Verify at the official NPI Registry.