Active NPI
Elaine Fresco, RN, CNM
- Advanced Practice Midwife
- Panorama City, CA
National Provider Identifier
1093922817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- 62
- Practice address
- 15251 Roscoe Blvd
Panorama City, CA 91402-4401 - Phone
- (818) 894-0974
- Fax
- (818) 894-0804
- NPI assigned
- May 17, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | 62 | CA | Primary |
Addresses
Primary practice location
15251 Roscoe Blvd
Panorama City, CA 91402-4401
Mailing address
2040 N Alta Vista Ave
Los Angeles, CA 90046-1801
Phone (323) 656-0246
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
- Certified Nurse Midwife, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62 | CA | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093922817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2040 N ALTA VISTA AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900461801",
"telephone_number": "323-656-0246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15251 ROSCOE BLVD",
"city": "PANORAMA CITY",
"state": "CA",
"postal_code": "914024401",
"telephone_number": "818-894-0974",
"fax_number": "818-894-0804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRESCO",
"first_name": "ELAINE",
"name_prefix": "Ms.",
"credential": "RN, CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "CA",
"license": "62",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Panorama City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.