Individual provider Active NPI

Nicholas Fernando, RN

  • Registered Nurse
  • Cerritos, CA
National Provider Identifier
1164075727
Registry record updated Jul 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95039413 Issued in CA
Practice address
10802 College PL
Cerritos, CA 90703-1579
Phone
(562) 924-9581
Fax
(562) 924-1804
NPI assigned
Jul 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95039413 CA Primary

Addresses

Primary practice location

10802 College PL
Cerritos, CA 90703-1579

Mailing address

10802 College PL
Cerritos, CA 90703-1579
Phone (562) 924-9581

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
95039413CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1164075727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10802 COLLEGE PL",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907031579",
            "telephone_number": "562-924-9581",
            "fax_number": "562-924-1804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10802 COLLEGE PL",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907031579",
            "telephone_number": "562-924-9581",
            "fax_number": "562-924-1804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDO",
        "first_name": "NICHOLAS",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-22",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95039413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; 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.