Active NPI
Raisa Angelica Nerosa
- Pharmacist
- Hawthorne, CA
National Provider Identifier
1104370063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 74726
- Practice address
- 13921 Kornblum Ave Unit 18
Hawthorne, CA 90250-8179 - Phone
- (310) 951-7059
- NPI assigned
- Aug 9, 2016
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 74726 | CA | Primary |
Addresses
Primary practice location
13921 Kornblum Ave Unit 18
Hawthorne, CA 90250-8179
Mailing address
13921 Kornblum Ave Unit 18
Hawthorne, CA 90250-8179
Phone (310) 951-7059
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
| License | State | Type | Specialty |
|---|---|---|---|
| 74726 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470700800000",
"number": "1104370063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13921 KORNBLUM AVE UNIT 18",
"city": "HAWTHORNE",
"state": "CA",
"postal_code": "902508179",
"telephone_number": "310-951-7059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13921 KORNBLUM AVE UNIT 18",
"city": "HAWTHORNE",
"state": "CA",
"postal_code": "902508179",
"telephone_number": "310-951-7059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEROSA",
"first_name": "RAISA ANGELICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-09",
"last_updated": "2016-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "74726",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hawthorne, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.