Individual provider Active NPI

Edenmae Chu-Panganiban, NP

  • Family Nurse Practitioner
  • Oxnard, CA
National Provider Identifier
1083478796
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95029438 Issued in CA
Practice address
1900 Outlet Center Dr
Oxnard, CA 93036-0677
Phone
(805) 983-8049
Fax
(805) 983-8076
NPI assigned
Feb 13, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 95029438 CA Primary

Addresses

Primary practice location

1900 Outlet Center Dr
Oxnard, CA 93036-0677

Mailing address

1200 W Gonzales Rd
Oxnard, CA 93036-3072

Other practice location 1

2438 N Ponderosa Dr Ste C101
Camarillo, CA 93010-2465
Phone (805) 383-9727

Other practice location 2

2705 Loma Vista Rd Ste 101
Ventura, CA 93003-1596
Phone (805) 383-9727

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
I20240829001044 CA Practitioner - Nurse Practitioner 7214476688 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95029438CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Housecall Doctors Medical Group Inc Single Specialty CurrentSince Sep 24, 2024 Accepting new patients
Osher Resources Inc Single Specialty CurrentSince Jul 1, 2024 Accepting new patients
Vista del Mar Medical Group, Inc Single Specialty Past Accepting new patients

Locations

3800 Kilroy Airport Way
Ste 270
Long Beach, CA 90806
Phone (949) 366-1053

6350 Laurel Canyon Blvd
Ste 205
North Hollywood, CA 91606
Phone (818) 325-2090

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FCFGBD

Organizations & group practices 3

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": "1707782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1083478796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W GONZALES RD",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930363072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 OUTLET CENTER DR",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930360677",
            "telephone_number": "805-983-8049",
            "fax_number": "805-983-8076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2438 N Ponderosa Dr Ste C101",
            "address_purpose": "LOCATION",
            "city": "Camarillo",
            "state": "CA",
            "postal_code": "930102465",
            "country_code": "US",
            "telephone_number": "805-383-9727",
            "fax_number": "805-764-0176",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2705 Loma Vista Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930031596",
            "country_code": "US",
            "telephone_number": "805-383-9727",
            "fax_number": "805-764-0176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHU-PANGANIBAN",
        "first_name": "EDENMAE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-13",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95029438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.