Individual provider Active NPI

Courtenay Lynn Juliano, FNP-BC

  • Family Nurse Practitioner
  • Alhambra, CA
National Provider Identifier
1104692425
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95097458 Issued in CA
Practice address
100 E Huntington Dr Ste 209
Alhambra, CA 91801-1022
Phone
(323) 264-7796
NPI assigned
Nov 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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 95097458 CA Primary

Addresses

Primary practice location

100 E Huntington Dr Ste 209
Alhambra, CA 91801-1022

Mailing address

100 E Huntington Dr Ste 209
Alhambra, CA 91801-1022
Phone (323) 264-7796

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
I20240711001630 CA Practitioner - Nurse Practitioner 7416492764 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
California Wound Healing Medical Group Inc.Group PAC ID 7315033198, 21 clinicians

Practice addresses (Care Compare)

100 E Huntington Dr
Alhambra, CA 91801-1022
Phone (323) 264-7796

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Edge Medical Group - Ca CurrentSince Dec 9, 2025 Accepting new patients
New Hope Podiatry Group Inc. CurrentSince Dec 29, 2024 Accepting new patients
California Wound Healing Medical Group Inc. CurrentSince May 16, 2024 Accepting new patients

Locations

100 E Huntington Dr
Ste 209
Alhambra, CA 91801
Phone (323) 262-4146

100 E Huntington Dr
Ste 203
Alhambra, CA 91801

3612 E 1st St
#1-2
Los Angeles, CA 90063
Phone (323) 262-4146

Organizations & group practices 3

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": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1104692425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E HUNTINGTON DR STE 209",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918011022",
            "telephone_number": "323-264-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E HUNTINGTON DR STE 209",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918011022",
            "telephone_number": "323-264-7796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JULIANO",
        "first_name": "COURTENAY",
        "middle_name": "LYNN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-28",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95097458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alhambra, CA

Sources for this page

Verify at the official NPI Registry.