Individual provider Active NPI

Dianycza Covarrubias

  • Family Nurse Practitioner
  • Dinuba, CA
National Provider Identifier
1104429182
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95015442 Issued in CA
Practice address
355 Monte Vista Dr
Dinuba, CA 93618-9228
Phone
(559) 595-7650
NPI assigned
Nov 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

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 NP95015442 CA Primary

Addresses

Primary practice location

355 Monte Vista Dr
Dinuba, CA 93618-9228

Mailing address

5237 W Modoc Ave
Visalia, CA 93291-9186
Phone (559) 305-1593

Other practice location 1

1014 San Juan Ave
Exeter, CA 93221-1312
Phone (559) 967-0072

Other identifiers 1

IdentifierTypeStateIssuer
NP95015442OtherCAFNP BRN LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Dinuba Direct

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
I20210204000025 CA Order and Referring Only - Nurse Practitioner 7315351244

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95015442CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kaweah Delta Health Care District Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1104429182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5237 W MODOC AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932919186",
            "telephone_number": "559-305-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 MONTE VISTA DR",
            "city": "DINUBA",
            "state": "CA",
            "postal_code": "936189228",
            "telephone_number": "559-595-7650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1014 San Juan Ave",
            "address_purpose": "LOCATION",
            "city": "Exeter",
            "state": "CA",
            "postal_code": "932211312",
            "country_code": "US",
            "telephone_number": "559-967-0072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COVARRUBIAS",
        "first_name": "DIANYCZA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95015442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FNP BRN LICENSE",
            "identifier": "NP95015442",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Dinuba",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "Dinuba",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Clinic",
            "address_1": "355 Monte Vista Dr",
            "city": "Dinuba",
            "state": "CA",
            "country_code": "US",
            "postal_code": "936189228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dinuba, CA

Sources for this page

Verify at the official NPI Registry.