Individual provider Active NPI

Fatima G Urquilla Soto, MSN FNP-C

  • Nurse Practitioner
  • Huntington Park, CA
National Provider Identifier
1063151603
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95025775 Issued in CA
Practice address
6601 Rugby Ave Ste 300
Huntington Park, CA 90255-4046
Phone
(323) 582-1177
NPI assigned
Jun 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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 95172261 CA
Nurse Practitioner 363L00000X 95025775 CA Primary

Addresses

Primary practice location

6601 Rugby Ave Ste 300
Huntington Park, CA 90255-4046

Mailing address

13934 Facade Ave
Paramount, CA 90723-2107

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
I20240108006112 CA Order and Referring Only - Nurse Practitioner 9032565528

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
95025775CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1063151603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13934 FACADE AVE",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907232107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 RUGBY AVE STE 300",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902554046",
            "telephone_number": "323-582-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URQUILLA SOTO",
        "first_name": "FATIMA",
        "middle_name": "G",
        "credential": "MSN FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95172261",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95025775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Park, CA

Sources for this page

Verify at the official NPI Registry.