NPIMap

Organization Active NPI

Ellen Musakwa

  • Clinic/Center
  • Riverside, CA
National Provider Identifier
1255704276
Registry record updated Nov 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
95003212 Issued in CA
Legal business name
ELLEN MUSAKWA
Practice address
4121 Brockton Ave
104
Riverside, CA 92501-3442
Phone
(951) 778-0032
NPI assigned
Nov 13, 2015
Organization subpart
Yes
Parent organization
ELLEN MUSAKWAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 13, 2015

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

Authorized official

Name
Ellen Musakwa, FNPNPI 1083074306
Title
FNP
Phone
(951) 966-0193

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 95003212 CA Primary

Addresses

Primary practice location

4121 Brockton Ave
104
Riverside, CA 92501-3442

Mailing address

37657 Brutus Way
Beaumont, CA 92223-8056

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1447372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447372800000",
    "number": "1255704276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37657 BRUTUS WAY",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922238056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 BROCKTON AVE",
            "address_2": "104",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013442",
            "telephone_number": "951-778-0032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLEN MUSAKWA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELLEN MUSAKWA",
        "enumeration_date": "2015-11-13",
        "last_updated": "2015-11-13",
        "status": "A",
        "authorized_official_last_name": "MUSAKWA",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "951-966-0193",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "95003212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2015; 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.