Individual provider Active NPI

Carolina Funk, RN

  • Registered Nurse
  • Carson, CA
National Provider Identifier
1255697496
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
769604 Issued in CA
Practice address
23601 Avalon Blvd
Suite # 207
Carson, CA 90745
Phone
(310) 513-0687
Fax
(310) 513-0689
NPI assigned
Apr 2, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 769604 CA Primary

Addresses

Primary practice location

23601 Avalon Blvd
Suite # 207
Carson, CA 90745

Mailing address

23601 Avalon Blvd
Suite # 207
Carson, CA 90745
Phone (310) 513-0687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
769604CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Transitions Home Health, Inc. CurrentSince Jun 30, 2024 Accepting new patients

Locations

23601 Avalon Blvd
Ste 207
Carson, CA 90745
Phone (310) 513-0687

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333324800000",
    "number": "1255697496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23601 AVALON BLVD",
            "address_2": "SUITE # 207",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "90745",
            "telephone_number": "310-513-0687",
            "fax_number": "310-513-0689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23601 AVALON BLVD",
            "address_2": "SUITE # 207",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "90745",
            "telephone_number": "310-513-0687",
            "fax_number": "310-513-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "CAROLINA",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "769604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.