Individual provider Active NPI

Vanessa Carlos, NP

  • Nurse Practitioner
  • San Fernando, CA
National Provider Identifier
1093683286
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN95161183 Issued in CA
Practice address
241 N. Maclay Ave
Suite 100
San Fernando, CA 91340-2909
Phone
(818) 930-4337
NPI assigned
Oct 28, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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 RN95161183 CA Primary

Addresses

Primary practice location

241 N. Maclay Ave
Suite 100
San Fernando, CA 91340-2909

Mailing address

3833 Sourdough Rd
Acton, CA 93510-1225
Phone (818) 930-4337

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

State licenses

LicenseStateTypeSpecialty
RN95161183CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1761609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1093683286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3833 SOURDOUGH RD",
            "city": "ACTON",
            "state": "CA",
            "postal_code": "935101225",
            "telephone_number": "818-930-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 N. MACLAY AVE",
            "address_2": "SUITE 100",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913402909",
            "telephone_number": "818-930-4337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLOS",
        "first_name": "VANESSA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-28",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "RN95161183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Fernando, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; 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.