Individual provider Active NPI

Tammi Lorraine Harris, N.P

  • Gerontology Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1215256011
Registry record updated Mar 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
14292 Issued in CA
Practice address
9233 W Pico Blvd
Suite 220
Los Angeles, CA 90035-1386
Phone
(310) 356-8146
Fax
(818) 356-8142
NPI assigned
May 19, 2010
Last updated
Mar 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 14292 CA Primary

Addresses

Primary practice location

9233 W Pico Blvd
Suite 220
Los Angeles, CA 90035-1386

Mailing address

4911 Van Nuys Blvd
Suite 307
Sherman Oaks, CA 91403-1716
Phone (818) 981-7111

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
I20101013000482 CA Practitioner - Nurse Practitioner 0345432001 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14292CAMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
Derderyan Medical Group Inc. CurrentSince Apr 1, 2016 Accepting new patients
Jha Geriatric Services, Inc CurrentSince Apr 4, 2017 Accepting new patients
Jha Geriatric Services, Inc CurrentSince Apr 4, 2017 Accepting new patients
Access Healthcare Associates a Medical Corporation PastSince Jun 1, 2007 Accepting new patients

Locations

18855 Victory Blvd
Reseda, CA 91335
Phone (818) 774-3000

7150 Tampa Ave
Reseda, CA 91335
Phone (818) 757-4447

4955 Van Nuys Blvd
Ste 308
Van Nuys, CA 91403
Phone (818) 387-6114

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12859/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": "1274227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457740800000",
    "number": "1215256011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4911 VAN NUYS BLVD",
            "address_2": "SUITE 307",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031716",
            "telephone_number": "818-981-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9233 W PICO BLVD",
            "address_2": "SUITE 220",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351386",
            "telephone_number": "310-356-8146",
            "fax_number": "818-356-8142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "TAMMI",
        "middle_name": "LORRAINE",
        "credential": "N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-19",
        "last_updated": "2016-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "14292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.