Individual provider Active NPI

Estarla B Beltran

  • Licensed Vocational Nurse
  • Rancho Cucamonga, CA
National Provider Identifier
1114786274
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
202249 Issued in CA
Practice address
11755 Malaga Dr Unit 1128
Rancho Cucamonga, CA 91730-8127
Phone
(909) 782-0550
NPI assigned
Mar 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 202249 CA Primary

Addresses

Primary practice location

11755 Malaga Dr Unit 1128
Rancho Cucamonga, CA 91730-8127

Mailing address

11755 Malaga Dr Unit 1128
Rancho Cucamonga, CA 91730-8127
Phone (909) 782-0550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
202249CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1114786274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11755 MALAGA DR UNIT 1128",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917308127",
            "telephone_number": "909-782-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11755 MALAGA DR UNIT 1128",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917308127",
            "telephone_number": "909-782-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELTRAN",
        "first_name": "ESTARLA",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "202249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.