Individual provider Active NPI

Joy Tuesday Ramas Engracia, NP-C

  • Family Nurse Practitioner
  • Patton, CA
National Provider Identifier
1235401050
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP21410 Issued in CA
Practice address
3102 E Highland Ave
Patton, CA 92369-7813
Phone
(909) 425-7000
NPI assigned
Feb 9, 2012
Last updated
Jan 9, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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 NP21410 CA Primary

Addresses

Primary practice location

3102 E Highland Ave
Patton, CA 92369-7813

Mailing address

3102 E Highland Ave
Patton, CA 92369-7813
Phone (909) 425-7000

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
I20141030000026 CA Practitioner - Nurse Practitioner 5092936344 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21410CAMDClinical Social Worker
NP21410CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals CurrentSince Aug 18, 2014 Accepting new patients
Department of State Hospitals Current Accepting new patients
Department of State Hospitals CurrentSince Aug 18, 2014 Accepting new patients

Locations

3102 E Highland Ave
Patton, CA 92369
Phone (909) 425-7000

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

Organizations & group practices 3

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": "1328745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1235401050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 E HIGHLAND AVE",
            "city": "PATTON",
            "state": "CA",
            "postal_code": "923697813",
            "telephone_number": "909-425-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 E HIGHLAND AVE",
            "city": "PATTON",
            "state": "CA",
            "postal_code": "923697813",
            "telephone_number": "909-425-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGRACIA",
        "first_name": "JOY TUESDAY",
        "middle_name": "RAMAS",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-09",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP21410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patton, CA

Sources for this page

Verify at the official NPI Registry.