Individual provider Active NPI

Miki Haraguni

  • Family Nurse Practitioner
  • Thousand Oaks, CA
National Provider Identifier
1104368869
Registry record updated May 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95005335 Issued in CA
Practice address
2791 Agoura Rd
Thousand Oaks, CA 91361-3101
Phone
(805) 495-4938
NPI assigned
Nov 12, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95005335 CA Primary

Addresses

Primary practice location

2791 Agoura Rd
Thousand Oaks, CA 91361-3101

Mailing address

12 Sherwood Dr
Westlake Village, CA 91361-4810

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170320000545 CA Practitioner - Nurse Practitioner 3577848332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Regents of the University of CaliforniaGroup PAC ID 1355248584, 1,426 clinicians

Practice addresses (Care Compare)

1250 La Venta Dr
Suite 202
Westlake Village, CA 91361-3769
Phone (805) 496-5153

Hospital & facility affiliations

  • Los Robles Hospital & Medical Center Hospital, Thousand Oaks, CA, CCN 050549

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California CurrentSince Mar 1, 2017 Accepting new patients
The Regents of the University of California CurrentSince Mar 1, 2017 Accepting new patients

Locations

File 55737
Los Angeles, CA 90074

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

1250 La Venta Dr
Ste 202
Westlake Vlg, CA 91361
Phone (805) 496-5153

1250 La Venta Dr
Ste 211
Westlake Vlg, CA 91361
Phone (805) 494-6920

Interoperability endpoints

  • Direct secure messaging: mharaguni33123@direct.uclahealth.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1478908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495756800000",
    "number": "1104368869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 SHERWOOD DR",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913614810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2791 AGOURA RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913613101",
            "telephone_number": "805-495-4938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARAGUNI",
        "first_name": "MIKI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-12",
        "last_updated": "2017-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.