Individual provider Active NPI

Reesha Javaid, FNP

  • Family Nurse Practitioner
  • Valencia, CA
National Provider Identifier
1134979743
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F01240875 Issued in CA
Practice address
25115 Avenue Stanford # A104
Valencia, CA 91355-1290
Phone
(661) 468-7405
NPI assigned
Mar 26, 2024
Last updated
Mar 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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 F01240875 CA Primary

Addresses

Primary practice location

25115 Avenue Stanford # A104
Valencia, CA 91355-1290

Mailing address

21725 Shallot CT
Saugus, CA 91350-1638
Phone (661) 309-2027

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
I20240605002669 CA Practitioner - Nurse Practitioner 1557803541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tarzana Treatment Centers IncGroup PAC ID 5991897845, 55 clinicians

Practice addresses (Care Compare)

8330 Reseda Blvd
Northridge, CA 91324-4619
Phone (800) 996-1051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F01240875CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel Dixon Family Health Center, Inc CurrentSince Apr 13, 2025 Accepting new patients
Tarzana Treatment Centers, Inc. Current Accepting new patients
Tarzana Treatment Centers, Inc. CurrentSince Apr 23, 2024 Accepting new patients
Tarzana Treatment Centers, Inc. CurrentSince Apr 23, 2024 Accepting new patients

Locations

8330 Reseda Blvd
Northridge, CA 91324
Phone (818) 534-1820

18646 Oxnard St
Tarzana, CA 91356
Phone (818) 654-3815

25115 Avenue Stanford
#A104
Valencia, CA 91355
Phone (661) 257-2339

Organizations & group practices 4

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": "1711411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1134979743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21725 SHALLOT CT",
            "city": "SAUGUS",
            "state": "CA",
            "postal_code": "913501638",
            "telephone_number": "661-309-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25115 AVENUE STANFORD # A104",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913551290",
            "telephone_number": "661-468-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVAID",
        "first_name": "REESHA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-26",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "F01240875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.