Traci Renee Vargas, NP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

16153 Issued in CA

Practice address

10418 Valley Blvd
El Monte, CA 91731-3600

Phone

(626) 453-8466

Fax

(626) 453-8465

NPI assigned

Mar 21, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Miss Traci Renee Gorman Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338940800000",
    "number": "1255456620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10418 VALLEY BLVD",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917313600",
            "telephone_number": "626-453-8466",
            "fax_number": "626-453-8465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10418 VALLEY BLVD",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917313600",
            "telephone_number": "626-453-8466",
            "fax_number": "626-453-8465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "TRACI",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2012-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "462956",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "16153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSING CA",
            "identifier": "NP16153",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSING CA",
            "identifier": "RN462956",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "GORMAN",
            "middle_name": "RENEE",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Valley Mall Dental MGMT, Inc
• Briana Kay Van Scoy, M.A.
• Gabriella M Vargas
• Myrna Vargas, LCSW
• Susana Vargas, FNP
• Rizzyannmae Apoldo Vasallo, LVN
• Elia Vasquez-Brooks, MS
• Anthony Vasquez
• Carina Gladys Vasquez, PAC
• Jaclyn Vasquez

• Women's Health Nurse Practitioner in El Monte, CA
• Providers in El Monte, CA by specialty
• Women's Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.