Individual provider Active NPI

Iman Amira Autman

  • Medical-Surgical Clinical Nurse Specialist
  • La Jolla, CA
National Provider Identifier
1184579070
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Clinical Nurse SpecialistTaxonomy code 364SM0705X
License
CNS5500 Issued in CA
Practice address
9888 Genesee Ave
La Jolla, CA 92037-1205
Phone
(858) 834-1798
NPI assigned
Mar 4, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Clinical Nurse SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 364SM0705X CNS5500 CA Primary

Addresses

Primary practice location

9888 Genesee Ave
La Jolla, CA 92037-1205

Mailing address

10014 Paseo Montril Apt 105
San Diego, CA 92129-3918
Phone (619) 300-5584

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
CNS5500CAMDMedical-Surgical Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1772582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1184579070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10014 PASEO MONTRIL APT 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921293918",
            "telephone_number": "619-300-5584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9888 GENESEE AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371205",
            "telephone_number": "858-834-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUTMAN",
        "first_name": "IMAN",
        "middle_name": "AMIRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-04",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SM0705X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Medical-Surgical",
            "state": "CA",
            "license": "CNS5500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; 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.