Individual provider Active NPI

Angela Marie Granados, CNM

  • Advanced Practice Midwife
  • Whittier, CA
National Provider Identifier
1265784698
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
2023 Issued in CA
Practice address
12462 Putnam St
Suite #303
Whittier, CA 90602-1048
Phone
(562) 789-5440
Fax
(562) 789-4440
NPI assigned
Oct 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 22484 CA
Advanced Practice Midwife 367A00000X 2023 CA Primary

Addresses

Primary practice location

12462 Putnam St
Suite #303
Whittier, CA 90602-1048

Mailing address

12462 Putnam St
Suite #303
Whittier, CA 90602-1048
Phone (562) 789-5440

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141231001216 CA Practitioner - Certified Nurse Midwife (CNM) 5092038877 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22484CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pih Health Physicians CurrentSince Nov 16, 2014 Accepting new patients
Pih Health Physicians CurrentSince Nov 16, 2014 Accepting new patients
Pih Health Physicians Current Accepting new patients

Locations

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

12462 Putnam St
Ste 303
Whittier, CA 90602
Phone (562) 789-5440

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1265784698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12462 PUTNAM ST",
            "address_2": "SUITE #303",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906021048",
            "telephone_number": "562-789-5440",
            "fax_number": "562-789-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12462 PUTNAM ST",
            "address_2": "SUITE #303",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906021048",
            "telephone_number": "562-789-5440",
            "fax_number": "562-789-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANADOS",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-09",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "22484",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "2023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.