Individual provider Active NPI

Erica Dawn Fitzgibbons, NP-C

  • Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1063729648
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP19176 Issued in CA
Practice address
1500 San Pablo St FL 2
Los Angeles, CA 90033-5313
Phone
(323) 442-8541
NPI assigned
Sep 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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 NP19176 CA Primary

Addresses

Primary practice location

1500 San Pablo St FL 2
Los Angeles, CA 90033-5313

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-8541

Other practice location 1

14445 Olive View Dr
Sylmar, CA 91342-1437
Phone (747) 210-3107

Other practice location 2

1200 N State St
Los Angeles, CA 90033-1029
Phone (661) 212-4778

Other names 1

  • Erica Dawn Husted Former name

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
I20120404000977 CA Practitioner - Nurse Practitioner 0840450532 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles Auditor Controller CurrentSince Apr 1, 2012 Accepting new patients
Willow Brook Critical Care Medical Group, Inc CurrentSince Mar 1, 2020 Accepting new patients
County of Los Angeles CurrentSince Apr 1, 2012 Accepting new patients
County of Los Angeles Current Accepting new patients
Sycamore Hill Hospitalist Medical Group Inc CurrentSince Dec 15, 2019 Accepting new patients
Usc Care Medical Group, Inc CurrentSince May 1, 2022 Accepting new patients
Usc Care Medical Group, Inc CurrentSince May 1, 2022 Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1420 S Central Ave
Glendale, CA 91204
Phone (818) 502-1900

1500 San Pablo St
Fl 2
Los Angeles, CA 90033
Phone (323) 442-8541

1520 San Pablo St
Ste LL1600
Los Angeles, CA 90033
Phone (323) 442-8541

1200 N State St
Los Angeles, CA 90089
Phone (323) 226-2170

1300 N Vermont Ave
Los Angeles, CA 90027
Phone (213) 413-3000

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

Organizations & group practices 9

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": "1283472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1063729648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-8541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SAN PABLO ST FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335313",
            "telephone_number": "323-442-8541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14445 Olive View Dr",
            "address_purpose": "LOCATION",
            "city": "Sylmar",
            "state": "CA",
            "postal_code": "913421437",
            "country_code": "US",
            "telephone_number": "747-210-3107",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 N State St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900331029",
            "country_code": "US",
            "telephone_number": "661-212-4778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITZGIBBONS",
        "first_name": "ERICA",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-03",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP19176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICA",
            "last_name": "HUSTED",
            "middle_name": "DAWN",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.