Individual provider Active NPI

Janet Ellen Ursua, RN MSN NP

  • Nurse Practitioner
  • Rancho Cucamonga, CA
National Provider Identifier
1114093101
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
383886 Issued in CA
Practice address
7777 Milliken Ave
240
Rancho Cucamonga, CA 91730-6780
Phone
(909) 941-0247
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 383886 CA Primary

Addresses

Primary practice location

7777 Milliken Ave
240
Rancho Cucamonga, CA 91730-6780

Mailing address

11873 Saybrock Dr
Rancho Cucamonga, CA 91730-8206
Phone (909) 944-6617

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
I20150107001780 CA Practitioner - Nurse Practitioner 5799008298

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
383886CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lothar McMillian M D Inc CurrentSince Oct 11, 2014 Accepting new patients

Locations

7777 Milliken Ave
Ste 240
Rch Cucamonga, CA 91730
Phone (909) 429-2864

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1114093101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11873 SAYBROCK DR",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917308206",
            "telephone_number": "909-944-6617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 MILLIKEN AVE",
            "address_2": "240",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917306780",
            "telephone_number": "909-941-0247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URSUA",
        "first_name": "JANET",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "RN MSN NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "383886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.