Individual provider Active NPI

Tamera Torres, NP

  • Family Nurse Practitioner
  • Victorville, CA
National Provider Identifier
1104538230
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95023597 Issued in CA
Practice address
15095 Amargosa Rd Ste 101
Victorville, CA 92394-1875
Phone
(760) 596-3363
Fax
(760) 596-3366
NPI assigned
Dec 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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 95023597 CA Primary

Addresses

Primary practice location

15095 Amargosa Rd Ste 101
Victorville, CA 92394-1875

Mailing address

71780 San Jacinto Dr BLDG I
Rancho Mirage, CA 92270-5516
Phone (760) 568-3461

Other identifiers 1

IdentifierTypeStateIssuer
95023597OtherCANP LICENSE

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
I20250917003327 CA Practitioner - Nurse Practitioner 9739683376

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Southern California Keck School of Medicine, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

18092 Wika Rd
Suite 220
Apple Valley, CA 92307-2132

9461 La Vine St
Rancho Cucamonga, CA 91701-5811

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95023597CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1671494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1104538230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71780 SAN JACINTO DR BLDG I",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922705516",
            "telephone_number": "760-568-3461",
            "fax_number": "760-423-6273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15095 AMARGOSA RD STE 101",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923941875",
            "telephone_number": "760-596-3363",
            "fax_number": "760-596-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORRES",
        "first_name": "TAMERA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-20",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95023597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "95023597",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.