Individual provider Active NPI

Theresa Saracho, RN, MSN, FNP

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1164634614
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
16235 Issued in CA
Practice address
1240 N Mission Rd # T-11
Los Angeles, CA 90033-1019
Phone
(323) 226-3961
NPI assigned
May 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 16235 CA Primary

Addresses

Primary practice location

1240 N Mission Rd # T-11
Los Angeles, CA 90033-1019

Mailing address

1910 N Ditman Ave
Los Angeles, CA 90032-3719
Phone (626) 222-7098

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
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
16235CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1178323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164634614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 N DITMAN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900323719",
            "telephone_number": "626-222-7098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 N MISSION RD # T-11",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331019",
            "telephone_number": "323-226-3961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARACHO",
        "first_name": "THERESA",
        "credential": "RN, MSN, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "16235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.