Individual provider Active NPI

Maian Ngo

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1174208110
Registry record updated Feb 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95014137 Issued in CA
Practice address
8445 Camino Santa Fe Ste 215
San Diego, CA 92121-2650
Phone
(855) 839-8878
NPI assigned
Jun 19, 2023
Last updated
Feb 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95014137 CA Primary
Registered Nurse 163W00000X 95092615 CA

Addresses

Primary practice location

8445 Camino Santa Fe Ste 215
San Diego, CA 92121-2650

Mailing address

8445 Camino Santa Fe Ste 215
San Diego, CA 92121-2650

Other practice location 1

4695 MacArthur Ct # 1112A
Newport Beach, CA 92660-1882
Phone (949) 520-1490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95092615CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
California Care Wellness Medical Center Inc. CurrentSince Jan 1, 2024 Accepting new patients
Geri Connection CurrentSince Jan 1, 2024 Accepting new patients
Bay View Health Solutions CurrentSince Mar 3, 2025 Accepting new patients
Myndfull Care Management California PC CurrentSince Jan 1, 2024 Accepting new patients
Del Sur Healthcare CurrentSince Nov 1, 2024 Accepting new patients
Myndfull Care California PC CurrentSince Feb 28, 2024 Accepting new patients

Locations

1999 S Bascom Ave
Ste 700
Campbell, CA 95008
Phone (760) 978-8596

436 S Magnolia Ave
Ste 101
El Cajon, CA 92020
Phone (760) 978-8596

15644 Pomerado Rd
Ste 202
Poway, CA 92064
Phone (619) 320-8090

6280 Jackson Dr
Ste 8
San Diego, CA 92119
Phone (619) 464-1607

8445 Camino Santa Fe
Ste 215
San Diego, CA 92121
Phone (619) 541-3246

9436 W Lake Mead Blvd
Ste 5
Las Vegas, NV 89134
Phone (702) 328-7648

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706918400000",
    "number": "1174208110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8445 CAMINO SANTA FE STE 215",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8445 CAMINO SANTA FE STE 215",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212650",
            "telephone_number": "855-839-8878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4695 MacArthur Ct # 1112A",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "926601882",
            "country_code": "US",
            "telephone_number": "949-520-1490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGO",
        "first_name": "MAIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-19",
        "last_updated": "2024-02-03",
        "certification_date": "2024-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95014137",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95092615",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.