Active NPI
Jamila Ukelee Ponder, F.N.P.-C
- Family Nurse Practitioner
- Costa Mesa, CA
National Provider Identifier
1124215165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 15719
- Practice address
- 1150 Baker St
Costa Mesa, CA 92626-4111 - Phone
- (714) 662-7517
- NPI assigned
- Oct 3, 2007
- Last updated
- Oct 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 15719 | CA | Primary |
Addresses
Primary practice location
1150 Baker St
Costa Mesa, CA 92626-4111
Mailing address
3620 Monroe St Apt 111
Riverside, CA 92504-3350
Phone (951) 722-1295
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15719 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191369600000",
"number": "1124215165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3620 MONROE ST APT 111",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925043350",
"telephone_number": "951-722-1295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1150 BAKER ST",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926264111",
"telephone_number": "714-662-7517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PONDER",
"first_name": "JAMILA",
"middle_name": "UKELEE",
"credential": "F.N.P.-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-03",
"last_updated": "2007-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "15719",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.