Individual provider Active NPI

Jacqueline Maria Cotten, CFNP/CPNP

  • Family Nurse Practitioner
  • Oceanside, CA
National Provider Identifier
1073583985
Registry record updated Jan 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
349415 Issued in CA
Practice address
2122 S El Camino Real
Oceanside, CA 92054-6209
Phone
(760) 754-0974
Fax
(760) 945-3201
NPI assigned
Jan 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 349415 CA Primary
Family Nurse Practitioner 363LF0000X 4346 CA

Addresses

Primary practice location

2122 S El Camino Real
Oceanside, CA 92054-6209

Mailing address

105 Noreen PL
Oceanside, CA 92054-3850
Phone (760) 721-2863

Other identifiers 1

IdentifierTypeStateIssuer
4346OtherCANURSE PRACTITIONER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090225000553 CA Practitioner - Nurse Practitioner 9436215563 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
349415CAMDFamily Nurse Practitioner
4346CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic Medical Group of San Diego Inc Family CurrentSince Feb 5, 2008 Accepting new patients

Locations

2760 Fletcher Pkwy
El Cajon, CA 92020
Phone 6194614411 ext. 8221

Organizations & group practices 1

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231718400000",
    "number": "1073583985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 NOREEN PL",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920543850",
            "telephone_number": "760-721-2863",
            "fax_number": "760-945-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 S EL CAMINO REAL",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546209",
            "telephone_number": "760-754-0974",
            "fax_number": "760-945-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTEN",
        "first_name": "JACQUELINE",
        "middle_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "CFNP/CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2009-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "349415",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "4346",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER",
            "identifier": "4346",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.