Individual provider Active NPI

Maica De Vera Javien, NP-C

  • Family Nurse Practitioner
  • Fullerton, CA
National Provider Identifier
1255086443
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95017070 Issued in CA
Practice address
1837 Sunny Crest Dr
Fullerton, CA 92835-3616
Phone
(714) 446-5831
Fax
(714) 446-7910
NPI assigned
Feb 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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 95017070 CA Primary

Addresses

Primary practice location

1837 Sunny Crest Dr
Fullerton, CA 92835-3616

Mailing address

1837 Sunny Crest Dr
Fullerton, CA 92835-3616
Phone (714) 446-5831

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL mdevera@westcoastuniversity.edu

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
I20250331000000 CA Practitioner - Nurse Practitioner 9436594728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1837 Sunny Crest Dr
Fullerton, CA 92835-3616
Phone (714) 446-5831

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95017070CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Mar 3, 2025 Accepting new patients
Providence Medical Foundation CurrentSince Mar 3, 2025 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

1837 Sunny Crest Dr
Fullerton, CA 92835
Phone (714) 446-5831

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1255086443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1837 SUNNY CREST DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353616",
            "telephone_number": "714-446-5831",
            "fax_number": "714-446-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1837 SUNNY CREST DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353616",
            "telephone_number": "714-446-5831",
            "fax_number": "714-446-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVIEN",
        "first_name": "MAICA",
        "middle_name": "DE VERA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-16",
        "last_updated": "2025-07-03",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mdevera@westcoastuniversity.edu",
            "affiliation": "N",
            "address_1": "1127 Wilshire Blvd Ste 909",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900173910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.