Individual provider Active NPI

Mariel Lora

  • Registered Nurse
  • San Diego, CA
National Provider Identifier
1104439520
Registry record updated Oct 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95201595 Issued in CA
Practice address
5055 Ruffin Rd
San Diego, CA 92123-1617
Phone
(858) 573-7300
NPI assigned
Aug 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2020

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 95201595 CA Primary

Addresses

Primary practice location

5055 Ruffin Rd
San Diego, CA 92123-1617

Mailing address

5055 Ruffin Rd
San Diego, CA 92123-1617
Phone (858) 573-7300

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
95201595CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603497600000",
    "number": "1104439520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5055 RUFFIN RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231617",
            "telephone_number": "858-573-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5055 RUFFIN RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231617",
            "telephone_number": "858-573-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORA",
        "first_name": "MARIEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-25",
        "last_updated": "2020-10-24",
        "certification_date": "2020-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95201595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2020; 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.