Anita Minicucci, RNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

202949 Issued in CA

Practice address

1420 S Central Ave
Glendale, CA 91204-2508

Phone

(818) 502-4567

Fax

(818) 502-4568

NPI assigned

Mar 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235257551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31542 CALLE LOS PADRES",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925925816",
            "telephone_number": "951-303-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 S CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042508",
            "telephone_number": "818-502-4567",
            "fax_number": "818-502-4568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINICUCCI",
        "first_name": "ANITA",
        "name_prefix": "Mrs.",
        "credential": "RNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "202949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Glendale, CA
• Providers in Glendale, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.