Active NPI
Fredricka Gooseberry, RN
- Registered Nurse
- Los Angeles, CA
National Provider Identifier
1194418517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 750996
- Practice address
- 5850 S Main St
Los Angeles, CA 90003-1215 - Phone
- (323) 897-6105
- NPI assigned
- May 31, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 750996 | CA | Primary |
Addresses
Primary practice location
5850 S Main St
Los Angeles, CA 90003-1215
Mailing address
5850 S Main St
Los Angeles, CA 90003-1215
Phone (323) 897-6105
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 750996 | CA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685491200000",
"number": "1194418517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5850 S MAIN ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900031215",
"telephone_number": "323-897-6105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5850 S MAIN ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900031215",
"telephone_number": "323-897-6105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOOSEBERRY",
"first_name": "FREDRICKA",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-31",
"last_updated": "2023-05-31",
"certification_date": "2023-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "750996",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.