Individual provider Active NPI

Aia Therese Intrepido, FNP

  • Family Nurse Practitioner
  • South Pasadena, CA
National Provider Identifier
1184440612
Registry record updated Nov 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95032565 Issued in CA
Practice address
23 Short Way St
South Pasadena, CA 91030-4050
Phone
(213) 448-2113
NPI assigned
Nov 30, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2024

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 95032565 CA Primary

Addresses

Primary practice location

23 Short Way St
South Pasadena, CA 91030-4050

Mailing address

23 Short Way St
South Pasadena, CA 91030-4050

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
I20250218003862 CA Practitioner - Nurse Practitioner 5698295814 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1700 E Cesar E Chavez Ave
Suite 2700
Los Angeles, CA 90033-2434
Phone (310) 372-9999

2750 Sycamore Dr
Simi Valley, CA 93065-1500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network Current Accepting new patients
Adventist Health Physicians Network CurrentSince Feb 16, 2025 Accepting new patients
White Memorial Medical Center CurrentSince Feb 1, 2025 Accepting new patients
Adventist Health Physicians Network CurrentSince Feb 16, 2025 Accepting new patients

Locations

1720 E Cesar E Chavez Ave
Los Angeles, CA 90033
Phone (323) 260-5781

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1732924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732924800000",
    "number": "1184440612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 SHORT WAY ST",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910304050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 SHORT WAY ST",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910304050",
            "telephone_number": "213-448-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INTREPIDO",
        "first_name": "AIA THERESE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-30",
        "last_updated": "2024-11-30",
        "certification_date": "2024-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95032565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Pasadena, CA

Sources for this page

Verify at the official NPI Registry.