Randi Celeste Edwards

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95008623 Issued in CA

Practice address

8237 Rochester Ave Ste 110
Rancho Cucamonga, CA 91730-0717

Phone

(909) 477-3310

NPI assigned

Jun 12, 2018

Last updated

Jun 12, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Southern California Primary Medical Inc

  • Geriatric Medicine (Family Medicine) Physician
  • Apple Valley, CA
  • NPI 1043508559
  NPD (past)

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1093208316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8237 ROCHESTER AVE STE 110",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917300717",
            "telephone_number": "909-477-3310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8237 ROCHESTER AVE STE 110",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917300717",
            "telephone_number": "909-477-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "RANDI",
        "middle_name": "CELESTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95008623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shadi Ebrahim, LMFT
• Behnam Ebrahimi, M.D.
• Econo Drugs
• Fairy Ancheta Edades, P.T.A.
• Geoffrey Dean Edwards, CRNA
• Shannen Nicole Edwards
• Terrence Milo Edwards, PSYD
• Robert David Eggleston Jr.
• Ehab Ateia DDS Inc (All Care Dental Group)
• Joshua Ehinger, PT, DPT

• Family Nurse Practitioner in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; 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.