Active NPI
Socorro Banuelos I, RN
- Case Management Registered Nurse
- Los Angeles, CA
National Provider Identifier
1194903955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Registered Nurse
- License
- 617175
- Practice address
- 600 S Commonwealth Ave
# 800
Los Angeles, CA 90005-4001 - Phone
- (213) 742-6005
- Fax
- (213) 742-6009
- NPI assigned
- Feb 4, 2008
- 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 |
|---|---|---|---|---|
| Case Management Registered Nurse | 163WC0400X | 617175 | CA | Primary |
Addresses
Primary practice location
600 S Commonwealth Ave
# 800
Los Angeles, CA 90005-4001
Mailing address
600 S Commonwealth Ave
# 800
Los Angeles, CA 90005-4001
Phone (213) 742-6005
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 |
|---|---|---|---|
| 617175 | CA | MD | Case Management Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202083200000",
"number": "1194903955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 S COMMONWEALTH AVE",
"address_2": "# 800",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900054001",
"telephone_number": "213-742-6005",
"fax_number": "213-742-6009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 S COMMONWEALTH AVE",
"address_2": "# 800",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900054001",
"telephone_number": "213-742-6005",
"fax_number": "213-742-6009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANUELOS",
"first_name": "SOCORRO",
"name_suffix": "I",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-04",
"last_updated": "2008-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Case Management",
"state": "CA",
"license": "617175",
"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 Feb 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.