Individual provider Active NPI

Neyda Brodnansky, F.N.P.

  • Family Nurse Practitioner
  • San Pedro, CA
National Provider Identifier
1275748295
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
488307 Issued in CA
Practice address
1360 W 6TH St
#120
San Pedro, CA 90732-3514
Phone
(310) 428-4699
Fax
(310) 833-2462
NPI assigned
May 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

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 488307 CA Primary

Addresses

Primary practice location

1360 W 6TH St
#120
San Pedro, CA 90732-3514

Mailing address

1360 W 6TH St
#120
San Pedro, CA 90732-3514
Phone (310) 428-4699

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
I20120611000716 CA Practitioner - Nurse Practitioner 7810151404 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
488307CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation CurrentSince Mar 1, 2020 Accepting new patients
American Advanced Practice Network, P.C. CurrentSince May 1, 2020 Accepting new patients
Providence Facey Medical Foundation CurrentSince Mar 1, 2020 Accepting new patients
Dr Mona Shah Professional Corporation PastSince Jan 21, 2010 Accepting new patients
Providence Saint John'S Health Center Past Accepting new patients

Locations

26777 Agoura Rd
Ste 4
Calabasas, CA 91302
Phone (818) 880-2225

359 Carmen Dr
Camarillo, CA 93010
Phone (805) 914-5592

475 Foothill Blvd
Ste K
La Canada, CA 91011
Phone (818) 528-6377

8985 Venice Blvd
Los Angeles, CA 90034
Phone (310) 474-2152

2090 Westwood Blvd
Los Angeles, CA 90025
Phone (213) 813-4070

8000 W Sunset Blvd
Ste C110
Los Angeles, CA 90046
Phone (213) 412-0400

3215 N Sepulveda Blvd
Manhattan Beach, CA 90266
Phone (424) 295-0540

4730 Lincoln Blvd
Marina del Rey, CA 90292
Phone (424) 352-0371

19346 Nordhoff St
Northridge, CA 91324
Phone (818) 727-2024

3160 E Del Mar Blvd
Ste 110
Pasadena, CA 91107
Phone (626) 270-2400

6020 Seabluff Dr
Ste 1
Playa Vista, CA 90094
Phone (310) 862-0400

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

725 S Pacific Coast Hwy
Redondo Beach, CA 90277
Phone (424) 296-3100

395 Silver Spur Rd
Rolling Hills Estates, CA 90274
Phone (424) 323-3500

14550 Soledad Canyon Rd
#100
Santa Clarita, CA 91387
Phone (661) 488-7402

13303 Riverside Dr
Sherman Oaks, CA 91423
Phone (818) 287-7409

25548 The Old Rd
Ste U1
Stevenson Ranch, CA 91381
Phone (661) 556-9020

701 N Wendy Dr
Thousand Oaks, CA 91320
Phone (805) 375-4400

6440 Platt Ave
West Hills, CA 91307
Phone (818) 946-1103

111 S Westlake Blvd
Ste 110
Westlake Village, CA 91362
Phone (805) 557-8177

Organizations & group practices 5

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": "1178928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220400000000",
    "number": "1275748295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 W 6TH ST",
            "address_2": "#120",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323514",
            "telephone_number": "310-428-4699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 W 6TH ST",
            "address_2": "#120",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323514",
            "telephone_number": "310-428-4699",
            "fax_number": "310-833-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODNANSKY",
        "first_name": "NEYDA",
        "name_prefix": "Mrs.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-12",
        "last_updated": "2008-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "488307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

Verify at the official NPI Registry.