Individual provider Active NPI

Angelina Laroco Leiva, NP

  • Nurse Practitioner
  • Burbank, CA
National Provider Identifier
1063529592
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP15295 Issued in CA
Practice address
Mobile Medical & Nursing, Inc.
4161 West Kling Street, # 16
Burbank, CA 91505
Phone
(818) 843-5225
Fax
(818) 843-5224
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP15295 CA Primary

Addresses

Primary practice location

Mobile Medical & Nursing, Inc.
4161 West Kling Street, # 16
Burbank, CA 91505

Mailing address

1548 Noel Cir
Simi Valley, CA 93065-3752
Phone (805) 583-5616

Other identifiers 1

IdentifierTypeStateIssuer
NP15295OtherCANP LICENSE

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)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rivera Sanatarium Inc Past Accepting new patients
Mobile Medical & Nursing, Inc. Nurse Practitioner Past Accepting new patients

Organizations & group practices 2

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063529592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1548 NOEL CIR",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930653752",
            "telephone_number": "805-583-5616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MOBILE MEDICAL & NURSING, INC.",
            "address_2": "4161 WEST KLING STREET, # 16",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "91505",
            "telephone_number": "818-843-5225",
            "fax_number": "818-843-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIVA",
        "first_name": "ANGELINA",
        "middle_name": "LAROCO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP15295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "NP15295",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.