Individual provider Active NPI

Joanna Lizeth Vazquez, FNP

  • Family Nurse Practitioner
  • Imperial, CA
National Provider Identifier
1093440828
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95021057 Issued in CA
Practice address
516 W Aten Rd Ste 2
Imperial, CA 92251-9805
Phone
(760) 355-7730
Fax
(760) 355-7731
NPI assigned
Jul 16, 2022
Last updated
Nov 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95021057 CA Primary

Addresses

Primary practice location

516 W Aten Rd Ste 2
Imperial, CA 92251-9805

Mailing address

PO Box 432
Heber, CA 92249-0432
Phone (760) 554-9318

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
I20221111001768 CA Practitioner - Nurse Practitioner 4385011899 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ming-Wei Wu IncGroup PAC ID 4284726159, 38 clinicians

Practice addresses (Care Compare)

135 S State College Blvd
Suite 200
Brea, CA 92821-5805
Phone 88843488806

401 E Birch St
Suite a
Calexico, CA 92231-4526
Phone (760) 768-5246

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95021057CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Imperial Valley Family Care Medical Group Apc CurrentSince Oct 1, 2022 Accepting new patients
Ming-Wei Wu, Inc CurrentSince May 24, 2023 Accepting new patients
Imperial Valley Family Care Medical Group, Apc CurrentSince Oct 1, 2022 Accepting new patients
Valley Health Partners Apc CurrentSince Feb 1, 2023 Accepting new patients

Locations

125 S 5th St
Brawley, CA 92227
Phone (760) 344-8100

135 S State College Blvd
Ste 200
Brea, CA 92821
Phone (626) 283-5852

401 E Birch St
Ste A
Calexico, CA 92231
Phone (760) 768-5246

1550 N Imperial Ave
Ste 1
El Centro, CA 92243
Phone (760) 352-1731

1665 S Imperial Ave
Ste C
El Centro, CA 92243
Phone (760) 337-8300

516 W Aten Rd
Ste 2
Imperial, CA 92251
Phone (760) 355-7730

3750 S Jones Blvd
Ste 120
Las Vegas, NV 89103
Phone (702) 291-8828

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1657929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1093440828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 432",
            "city": "HEBER",
            "state": "CA",
            "postal_code": "922490432",
            "telephone_number": "760-554-9318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 W ATEN RD STE 2",
            "city": "IMPERIAL",
            "state": "CA",
            "postal_code": "922519805",
            "telephone_number": "760-355-7730",
            "fax_number": "760-355-7731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "JOANNA",
        "middle_name": "LIZETH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-16",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95021057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Imperial, CA

Sources for this page

Verify at the official NPI Registry.