Jay Santillana Lardizabal, MSN, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F04220387 Issued in CA

Practice address

6595 Cantata Dr
Eastvale, CA 92880-4534

Phone

(951) 987-1133

NPI assigned

May 4, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1651622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1124763164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6595 CANTATA DR",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928804534",
            "telephone_number": "951-987-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6595 CANTATA DR",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928804534",
            "telephone_number": "951-987-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARDIZABAL",
        "first_name": "JAY",
        "middle_name": "SANTILLANA",
        "name_prefix": "Mr.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-04",
        "last_updated": "2022-05-04",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "F04220387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louisa Lai
• Lisa Marie Lam
• Rolanda N/a Lane, PPS
• Christian C Lanot, M.D.
• Felipe De Jesus Lara, DC
• Raymond Charles Larriva, PSYCHIATRIC TECH.
• Hong-Chau Thi Le, O.D.
• Mandy Yenrue Lee, DDS
• Giselle Leoro
• Jazmine Leoro

• Family Nurse Practitioner in Eastvale, CA
• Providers in Eastvale, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; 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.