Active NPI
Blanca De Jesus Serrano, FNP-C
- Family Nurse Practitioner
- Apple Valley, CA
National Provider Identifier
1073114096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95014944
- Practice address
- 18144 Outer Hwy 18 Ste 200
Apple Valley, CA 92307-2212 - Phone
- (760) 242-7777
- NPI assigned
- Nov 5, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95014944 | CA | Primary |
Addresses
Primary practice location
18144 Outer Hwy 18 Ste 200
Apple Valley, CA 92307-2212
Mailing address
14218 Pioneer Rd
Apple Valley, CA 92307-4191
Phone (760) 881-7916
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95014944 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604534400000",
"number": "1073114096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14218 PIONEER RD",
"city": "APPLE VALLEY",
"state": "CA",
"postal_code": "923074191",
"telephone_number": "760-881-7916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18144 OUTER HWY 18 STE 200",
"city": "APPLE VALLEY",
"state": "CA",
"postal_code": "923072212",
"telephone_number": "760-242-7777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERRANO",
"first_name": "BLANCA",
"middle_name": "DE JESUS",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-05",
"last_updated": "2020-11-05",
"certification_date": "2020-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95014944",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Apple Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.