Individual provider Active NPI

Quita Hackett

  • Registered Nurse
  • Los Angeles, CA
National Provider Identifier
1104353234
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
401149 Issued in CA
Practice address
5850 S Main St
Los Angeles, CA 90003-1215
Phone
(323) 897-6287
NPI assigned
May 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 401149 CA Primary

Addresses

Primary practice location

5850 S Main St
Los Angeles, CA 90003-1215

Mailing address

5850 S Main St
Los Angeles, CA 90003-1215
Phone (323) 897-6287

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

State licenses

LicenseStateTypeSpecialty
401149CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1495152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1104353234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 S MAIN ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900031215",
            "telephone_number": "323-897-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5850 S MAIN ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900031215",
            "telephone_number": "323-897-6287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKETT",
        "first_name": "QUITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-19",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "401149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; 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.