Individual provider Active NPI

Rosalinda Valmeo Protacio, NP

  • Family Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1124213186
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP16799 Issued in CA
Practice address
710 S Central Ave Ste 330
Glendale, CA 91204-4647
Phone
(818) 395-7311
Fax
(818) 500-0957
NPI assigned
Sep 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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 NP16799 CA Primary

Addresses

Primary practice location

710 S Central Ave Ste 330
Glendale, CA 91204-4647

Mailing address

710 S Central Ave Ste 330
Glendale, CA 91204-4647
Phone (818) 395-7311

Other identifiers 1

IdentifierTypeStateIssuer
NP16799OtherCABRN

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
I20160909002455 CA Order and Referring Only - Nurse Practitioner 4587950928

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
California Primary Health Care Corp CurrentSince Apr 17, 2020 Accepting new patients
Dignicare Hospice Services LLC PastSince May 24, 2013 Accepting new patients

Locations

1510 S Central Ave
Ste 540
Glendale, CA 91204
Phone (818) 500-8739

710 S Central Ave
Ste 330
Glendale, CA 91204
Phone (818) 500-8739

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1124213186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 S CENTRAL AVE STE 330",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044647",
            "telephone_number": "818-395-7311",
            "fax_number": "818-500-0957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 S CENTRAL AVE STE 330",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044647",
            "telephone_number": "818-395-7311",
            "fax_number": "818-500-0957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROTACIO",
        "first_name": "ROSALINDA",
        "middle_name": "VALMEO",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-12",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP16799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRN",
            "identifier": "NP16799",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.