Individual provider Active NPI

Virginia Latta, NP, RN

  • Nurse Practitioner
  • Templeton, CA
National Provider Identifier
1083628002
Registry record updated Jan 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
153772 Issued in CA
Practice address
350 Posada LN
102
Templeton, CA 93465-4059
Phone
(805) 434-3699
Fax
(805) 434-4864
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 153772 CA Primary

Addresses

Primary practice location

350 Posada LN
102
Templeton, CA 93465-4059

Mailing address

350 Posada LN
#102
Templeton, CA 93465-4059
Phone (805) 434-3699

Other identifiers 1

IdentifierTypeStateIssuer
153772MedicaidCA

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
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
153772CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Reynaldo M. Cordero, M.D, Inc. PastSince Sep 17, 2015 Accepting new patients
Agile Occupational Medicine, PC PastSince Aug 3, 2025 Accepting new patients

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232582400000",
    "number": "1083628002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 POSADA LN",
            "address_2": "#102",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934654059",
            "telephone_number": "805-434-3699",
            "fax_number": "805-434-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 POSADA LN",
            "address_2": "102",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934654059",
            "telephone_number": "805-434-3699",
            "fax_number": "805-434-4864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATTA",
        "first_name": "VIRGINIA",
        "credential": "NP, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2009-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "153772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153772",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Templeton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2009; 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.