Individual provider Active NPI

Marriane Zurbano, NURSE PRACTITIONER

  • Nurse Practitioner
  • La Mesa, CA
National Provider Identifier
1174058762
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95006441 Issued in CA
Practice address
4579 Maple Ave Ste 1
La Mesa, CA 91941-3154
Phone
(619) 567-2258
Fax
(888) 628-6680
NPI assigned
Apr 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95006441 CA Primary

Addresses

Primary practice location

4579 Maple Ave Ste 1
La Mesa, CA 91941-3154

Mailing address

4579 Maple Ave Ste 1
La Mesa, CA 91941-3154
Phone (619) 567-2258

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL soap Health Information Exchange (HIE)

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
I20180503001256 CA Practitioner - Nurse Practitioner 5496019242 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cristina Tobon-Chung FNP a Professional Medical Corporation CurrentSince Jan 1, 2024 Accepting new patients
Ace Mobile Nursing Provider Inc. Nurse Practitioner CurrentSince Dec 1, 2022 Accepting new patients
Candelario Chiropractic a Professional Corporation PastSince Feb 1, 2010 Accepting new patients

Locations

3450 Bonita Rd
Ste 205
Chula Vista, CA 91910
Phone (619) 948-7530

2453 Fenton St
Chula Vista, CA 91914
Phone (619) 948-7530

7227 Broadway
Ste 402
Lemon Grove, CA 91945
Phone (619) 253-6451

7227 Broadway
Ste 405
Lemon Grove, CA 91945
Phone (213) 663-8836

Organizations & group practices 3

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": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1174058762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4579 MAPLE AVE STE 1",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919413154",
            "telephone_number": "619-567-2258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4579 MAPLE AVE STE 1",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919413154",
            "telephone_number": "619-567-2258",
            "fax_number": "888-628-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZURBANO",
        "first_name": "MARRIANE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-20",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95006441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "soap",
            "affiliation": "N",
            "endpointDescription": "direct message",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1333 Camino Del Rio S Ste 306",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921083520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.