NPIMap

Individual provider Active NPI

Sonia Delacruz

  • Specialist
  • Tarzana, CA
National Provider Identifier
1083005672
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A62510 Issued in CA
Practice address
18411 Clark St
Suite 302
Tarzana, CA 91356-3506
Phone
(818) 501-7276
Fax
(818) 996-7288
NPI assigned
Feb 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A62510 CA Primary

Addresses

Primary practice location

18411 Clark St
Suite 302
Tarzana, CA 91356-3506

Mailing address

18411 Clark St
Suite 302
Tarzana, CA 91356-3506
Phone (818) 501-7276

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A62510CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Sports Medicine a Medical Corporation Current Accepting new patients
Primary Care Sports Medicine a Medical Corporation Current Accepting new patients

Locations

18411 Clark St
Ste 302
Tarzana, CA 91356
Phone (818) 501-7276

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": "1424217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1083005672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18411 CLARK ST",
            "address_2": "SUITE 302",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563506",
            "telephone_number": "818-501-7276",
            "fax_number": "818-996-7288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18411 CLARK ST",
            "address_2": "SUITE 302",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563506",
            "telephone_number": "818-501-7276",
            "fax_number": "818-996-7288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELACRUZ",
        "first_name": "SONIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-18",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A62510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; 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.