Individual provider Active NPI

Maria Coleman Perdue

  • Student in an Organized Health Care Education/Training Program
  • Lancaster, CA
National Provider Identifier
1184165300
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
43807 10TH St W Ste D
Lancaster, CA 93534-4805
Phone
(661) 575-9365
NPI assigned
Mar 20, 2017
Last updated
Sep 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 00365636 CA
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

43807 10TH St W Ste D
Lancaster, CA 93534-4805

Mailing address

447 N El Molino Ave
Pasadena, CA 91101-1403
Phone (626) 577-8480

Other practice location 1

38736 Fortunato Ct
Palmdale, CA 93552-4182
Phone (661) 492-1284

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
00365636CAMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1184165300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 N EL MOLINO AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011403",
            "telephone_number": "626-577-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43807 10TH ST W STE D",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935344805",
            "telephone_number": "661-575-9365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "38736 Fortunato Ct",
            "address_purpose": "LOCATION",
            "city": "Palmdale",
            "state": "CA",
            "postal_code": "935524182",
            "country_code": "US",
            "telephone_number": "661-492-1284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERDUE",
        "first_name": "MARIA",
        "middle_name": "COLEMAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-20",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "CA",
            "license": "00365636",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; 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.