NPIMap

Individual provider Active NPI

Renita Jejuan Pullens, D.O.

  • General Practice Physician
  • Sherman Oaks, CA
National Provider Identifier
1093791667
Registry record updated Nov 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
20A8326 Issued in CA
Practice address
15315 Magnolia Blvd.
Roze Room Hospice of the Valley
Sherman Oaks, CA 91403
Phone
(818) 783-1002
Fax
(818) 783-1066
NPI assigned
Dec 15, 2005
Last updated
Nov 2, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 20A8326 CA Primary

Addresses

Primary practice location

15315 Magnolia Blvd.
Roze Room Hospice of the Valley
Sherman Oaks, CA 91403

Mailing address

23622 Calabasas Rd
Ste 250
Calabasas, CA 91302-1549
Phone (818) 591-3435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110120000463 CA Practitioner - Family Practice 6507894052 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
8326CAMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Medical Organization, a Medical Group Inc. CurrentSince Aug 11, 2014 Accepting new patients
Wound Care RX CurrentSince Jul 1, 2025 Accepting new patients
Franklin Hospice, Inc PastSince Feb 13, 2024 Accepting new patients
Alfa Alliance Hospice Inc PastSince May 1, 2023 Accepting new patients
Roze Room Hospice of the Valley Inc Past Accepting new patients

Locations

191 S Buena Vista St
Ste 200
Burbank, CA 91505
Phone (818) 887-2671

9528 Topanga Canyon Blvd
Chatsworth, CA 91311
Phone (818) 634-7091

8510 Balboa Blvd
Ste 150
Northridge, CA 91325
Phone (818) 637-2000

Interoperability endpoints

  • Direct secure messaging: renita.pullens.p1@direct.lakeside.nextgenshare.com

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Virtus HealthcareSan Marino, CA, CCN 921574 Hospice Contracted Managing Employee Jan 1, 2026
Franklin Hospice IncSun Valley, CA, CCN A11705 Hospice W-2 Managing Employee Feb 13, 2024
Valiant Hospice Care IncNorth Hollywood, CA, CCN B21551 Hospice W-2 Managing Employee Aug 1, 2025
Zirra Hospice Care IncNorth Hollywood, CA, CCN B41560 Hospice W-2 Managing Employee Nov 1, 2025
Alfa Alliance Hospice IncBurbank, CA, CCN B51639 Hospice W-2 Managing Employee (100%) May 1, 2023

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288656000000",
    "number": "1093791667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23622 CALABASAS RD",
            "address_2": "STE 250",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021549",
            "telephone_number": "818-591-3435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15315 MAGNOLIA BLVD.",
            "address_2": "ROZE ROOM HOSPICE OF THE VALLEY",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "91403",
            "telephone_number": "818-783-1002",
            "fax_number": "818-783-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLENS",
        "first_name": "RENITA",
        "middle_name": "JEJUAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-15",
        "last_updated": "2010-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "20A8326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.