Active NPI
Laura Mercado Halterman, DNP FNP-C
- Family Nurse Practitioner
- Victorville, CA
National Provider Identifier
1174019228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95009211
- Practice address
- 16245 Desert Knoll Dr
Victorville, CA 92395-4011 - Phone
- (760) 955-9555
- Fax
- (760) 955-8558
- NPI assigned
- Jul 2, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95009211 | CA | Primary |
Addresses
Primary practice location
16245 Desert Knoll Dr
Victorville, CA 92395-4011
Mailing address
17573 Century Plant Rd
Apple Valley, CA 92307-6995
Phone (760) 490-2445
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
| License | State | Type | Specialty |
|---|---|---|---|
| 95009211 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cal Choice Family Practice Inc | Family Medicine | Current | Accepting new patients |
Locations
16245 Desert Knoll Dr
Victorville, CA 92395
Phone (760) 245-1997
16519 Victor St
Ste 307
Victorville, CA 92395
Phone (760) 955-9555
Organizations & group practices 1
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": "1530489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713312000000",
"number": "1174019228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17573 CENTURY PLANT RD",
"city": "APPLE VALLEY",
"state": "CA",
"postal_code": "923076995",
"telephone_number": "760-490-2445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16245 DESERT KNOLL DR",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923954011",
"telephone_number": "760-955-9555",
"fax_number": "760-955-8558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALTERMAN",
"first_name": "LAURA",
"middle_name": "MERCADO",
"credential": "DNP FNP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-02",
"last_updated": "2024-04-17",
"certification_date": "2024-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95009211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.