Maryam Fathy, DNP, MSN, RN, NP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

21935 Issued in CA

Practice address

24451 Health Center Dr
Laguna Hills, CA 92653-3689

Phone

(949) 424-9730

Fax

(949) 452-7599

NPI assigned

Nov 24, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432080000000",
    "number": "1114255411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24451 HEALTH CENTER DR",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24451 HEALTH CENTER DR",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533689",
            "telephone_number": "949-424-9730",
            "fax_number": "949-452-7599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATHY",
        "first_name": "MARYAM",
        "credential": "DNP, MSN, RN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-24",
        "last_updated": "2015-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704259944",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "21935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fartash Farkhondehkish DDS Ms
• James Edwin Farthing, DDS
• Farzad Massoudi MD Incorporated
• Schahrokh Fatehi, D.D.S.
• Fathi Wellness and Chiropractic Corporation
• William Fazzalaro, PA-C
• Jeffrey F Feiner, M.D.
• Robert Gabriel Feldman, M.D.
• Brittany Fella, LMFT
• Caitlin Ferini

• Primary Care Nurse Practitioner in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.