Individual provider Active NPI

Tea A Renata

  • School Registered Nurse
  • Palm Springs, CA
National Provider Identifier
1083470439
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
95075691 Issued in CA
Practice address
150 District Center Dr
Palm Springs, CA 92264-3626
Phone
(760) 883-2703
NPI assigned
Feb 23, 2024
Last updated
Jun 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 938319-01 NY
School Registered Nurse 163WS0200X 95075691 CA Primary

Addresses

Primary practice location

150 District Center Dr
Palm Springs, CA 92264-3626

Mailing address

150 District Center Dr
Palm Springs, CA 92264-3626
Phone (760) 883-2703

Other practice location 1

2811 Queens Plz N Fl 5
Long Island City, NY 11101-4172
Phone (718) 391-8300

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
938319-01NYMDRegistered Nurse
95075691CAMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Springs Unified School District School PastSince Feb 25, 2024 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1708646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1083470439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 DISTRICT CENTER DR",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922643626",
            "telephone_number": "760-883-2703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 DISTRICT CENTER DR",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922643626",
            "telephone_number": "760-883-2703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2811 Queens Plz N Fl 5",
            "address_purpose": "LOCATION",
            "city": "Long Island City",
            "state": "NY",
            "postal_code": "111014172",
            "country_code": "US",
            "telephone_number": "718-391-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENATA",
        "first_name": "TEA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-23",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "938319-01",
            "primary": false
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "CA",
            "license": "95075691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.