Individual provider Active NPI

Rubiceli Hernandez, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Huntington Beach, CA
National Provider Identifier
1114359429
Registry record updated Aug 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20225 Issued in CA
Practice address
17122 Beach Blvd
Suite 102
Huntington Beach, CA 92647-5992
Phone
(714) 847-6545
NPI assigned
Aug 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2013

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 20225 CA Primary

Addresses

Primary practice location

17122 Beach Blvd
Suite 102
Huntington Beach, CA 92647-5992

Mailing address

17122 Beach Blvd
Suite 102
Huntington Beach, CA 92647-5992

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
I20150731015840 CA Practitioner - Nurse Practitioner 3870807423 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20225CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Health Physicians of Pih CurrentSince Apr 30, 2017 Accepting new patients
Pih Health Physicians CurrentSince Apr 30, 2017 Accepting new patients
Pih Health Physicians Current Accepting new patients
Infusion4Health CurrentSince Nov 4, 2023 Accepting new patients
Charles W Jackson MD Inc Past Accepting new patients
Choice Health Network Past Accepting new patients
Ameer F Moussa MD Inc Past Accepting new patients

Locations

1104 Buchanan Rd
Ste B5
Antioch, CA 94509
Phone (925) 757-9012

8339 Brimhall Rd
Ste 1301
Bakersfield, CA 93312

1125 E Spruce Ave
Ste 201
Fresno, CA 93720
Phone (559) 896-0400

2720 N Harbor Blvd
Ste 200
Fullerton, CA 92835
Phone (714) 449-6900

501 N Central Ave
Glendale, CA 91203
Phone (805) 505-7757

1400 Reynolds Ave
Ste 201
Irvine, CA 92614
Phone (702) 550-0124

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

79440 Corporate Center Dr
Ste 100
La Quinta, CA 92253

333 University Ave
Ste 140
Sacramento, CA 95825
Phone (916) 333-5800

4520 Executive Dr
Ste 227
San Diego, CA 92121
Phone (619) 333-3515

77 Rolling Oaks Dr
Ste 201
Thousand Oaks, CA 91361
Phone (805) 413-9099

440 N Mountain Ave
Ste 103
Upland, CA 91786

12522 Lambert Rd
Whittier, CA 90606
Phone (562) 789-5420

Interoperability endpoints

  • Direct secure messaging: valerie.brady.p1@direct.ifh.nextgenshare.com
  • Direct secure messaging: rubiceli.hernandez.1@25734.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/25734/brand/1/csg/21/fhir/r4

Organizations & group practices 7

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": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376006400000",
    "number": "1114359429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17122 BEACH BLVD",
            "address_2": "SUITE 102",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926475992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17122 BEACH BLVD",
            "address_2": "SUITE 102",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926475992",
            "telephone_number": "714-847-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "RUBICELI",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-09",
        "last_updated": "2013-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "20225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.