Individual provider Active NPI

Desiree Grace Rico

  • Hearing Instrument Specialist
  • Tarzana, CA
National Provider Identifier
1164125936
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
HA8374 Issued in CA
Practice address
19367 Victory Blvd Ste 14
Tarzana, CA 91335-6302
Phone
(818) 343-8116
NPI assigned
Mar 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X HA8374 CA Primary

Addresses

Primary practice location

19367 Victory Blvd Ste 14
Tarzana, CA 91335-6302

Mailing address

1920 Lucas St Unit 2
San Fernando, CA 91340-1668
Phone (303) 875-9459

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

State licenses

LicenseStateTypeSpecialty
HA8374CAMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Hearx West, LLC CurrentSince Mar 26, 2023 Accepting new patients
Hearx West Inc PastSince Mar 26, 2023 Accepting new patients

Locations

26504 Bouquet Canyon Rd
Santa Clarita, CA 91350
Phone (617) 999-9656

19367 Victory Blvd
Ste 14
Tarzana, CA 91335
Phone (818) 343-8116

21787 Ventura Blvd
Woodland Hills, CA 91364
Phone (818) 224-7695

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1164125936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 LUCAS ST UNIT 2",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913401668",
            "telephone_number": "303-875-9459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19367 VICTORY BLVD STE 14",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913356302",
            "telephone_number": "818-343-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICO",
        "first_name": "DESIREE",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-22",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CA",
            "license": "HA8374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; 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.