Individual provider Active NPI

Jessica Del Mundo Ercia, NP

  • Family Nurse Practitioner
  • Roseville, CA
National Provider Identifier
1215233465
Registry record updated Aug 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20478 Issued in CA
Practice address
3001 Douglas Blvd
Ste 150
Roseville, CA 95661-3851
Phone
(916) 241-9844
Fax
(916) 241-9845
NPI assigned
Feb 7, 2011
Last updated
Aug 13, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2014

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 20478 CA Primary

Addresses

Primary practice location

3001 Douglas Blvd
Ste 150
Roseville, CA 95661-3851

Mailing address

4264 Melody LN
Vallejo, CA 94591-6352
Phone (707) 688-3168

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
20478CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelong Medical Care Past Accepting new patients
La Clinica de la Raza, Inc. Past Accepting new patients
Chandan DS Cheema MD Inc PastSince May 1, 2007 Accepting new patients
Capital Medical Extended Care Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jdelmundoercia306498@direct.ochin.org
  • FHIR API: https://api.platform.athenahealth.com/19797/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1297036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407888000000",
    "number": "1215233465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4264 MELODY LN",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945916352",
            "telephone_number": "707-688-3168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 DOUGLAS BLVD",
            "address_2": "STE 150",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613851",
            "telephone_number": "916-241-9844",
            "fax_number": "916-241-9845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERCIA",
        "first_name": "JESSICA",
        "middle_name": "DEL MUNDO",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-07",
        "last_updated": "2014-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "20478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; 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.