NPIMap

Individual provider Active NPI

Florence A Mojica

  • Nursing Home Administrator
  • Beaumont, CA
National Provider Identifier
1053927756
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Home AdministratorTaxonomy code 376G00000X
License
6036944740 Issued in CA
Practice address
1651 Rose Ave
Beaumont, CA 92223-7174
Phone
(310) 592-5338
Fax
(844) 970-1027
NPI assigned
Sep 17, 2020
Last updated
Sep 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Home Administrator 376G00000X 6036944740 CA Primary

Addresses

Primary practice location

1651 Rose Ave
Beaumont, CA 92223-7174

Mailing address

1651 Rose Ave
Beaumont, CA 92223-7174
Phone (310) 592-5338

Other practice location 1

43 Sitara Ave
Beaumont, CA 92223-3110
Phone (310) 592-5338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6036944740CAMDNursing Home Administrator

Practice roles

OrganizationSpecialtyStatusNew patients
Amazing Grace Care Services LLC PastSince Sep 20, 2020 Accepting new patients

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1053927756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 ROSE AVE",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922237174",
            "telephone_number": "310-592-5338",
            "fax_number": "844-970-1027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 ROSE AVE",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922237174",
            "telephone_number": "310-592-5338",
            "fax_number": "844-970-1027"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43 Sitara Ave",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "CA",
            "postal_code": "922233110",
            "country_code": "US",
            "telephone_number": "310-592-5338",
            "fax_number": "844-970-1027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOJICA",
        "first_name": "FLORENCE",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-17",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": "CA",
            "license": "6036944740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.