Alexis Mimi Dede Rahwanji, FNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

NP95032884 Issued in CA

Practice address

9415 Mission Blvd
Jurupa Valley, CA 92509-2661

Phone

(833) 865-8263

NPI assigned

Nov 20, 2024

Sex

Female

Sole proprietor

Yes

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1732060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1093530354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22810 CARDINAL ST",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135760",
            "telephone_number": "510-734-0731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9415 MISSION BLVD",
            "city": "JURUPA VALLEY",
            "state": "CA",
            "postal_code": "925092661",
            "telephone_number": "833-865-8263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHWANJI",
        "first_name": "ALEXIS",
        "middle_name": "MIMI DEDE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-20",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "NP95032884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alejandra Pilat, BA
• Mia Nevaeh Pina
• Plan-It Life, Inc.
• Prime Age Health Services LLC
• Rahij Obid DDS
• Monica Gen Ramboz
• Carina Raquel Ramirez
• Chelsie Ramirez
• Hannah Christine Ramirez
• Phillip Ramirez Jr.

• Primary Care Nurse Practitioner in Jurupa Valley, CA
• Providers in Jurupa Valley, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.