Individual provider Active NPI

Bettina Dennise Chua, FNP-C

  • Family Nurse Practitioner
  • Canyon Country, CA
National Provider Identifier
1285489864
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95028852 Issued in CA
Practice address
19042 Soledad Canyon Rd
Canyon Country, CA 91351-3362
Phone
(661) 251-6300
NPI assigned
Apr 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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 95028852 CA Primary

Addresses

Primary practice location

19042 Soledad Canyon Rd
Canyon Country, CA 91351-3362

Mailing address

19042 Soledad Canyon Rd
Canyon Country, CA 91351-3362
Phone (661) 251-6300

Other practice location 1

17609 Ventura Blvd
Encino, CA 91316-3858
Phone (818) 774-2757

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
I20241031002961 CA Practitioner - Nurse Practitioner 8426589599 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prime Urgent Care IncGroup PAC ID 9537500954, 2 clinicians
SC Medical, Inc.Group PAC ID 6305001439, 10 clinicians

Practice addresses (Care Compare)

17609 Ventura Blvd
Suite 106
Encino, CA 91316-3866
Phone (818) 774-2457

19042 Soledad Canyon Rd
Santa Clarita, CA 91351-3362
Phone (661) 251-6300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95028852CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Urgent Care Inc CurrentSince Oct 1, 2024 Accepting new patients
SC Medical, Inc. CurrentSince Apr 10, 2025 Accepting new patients
California Primary Health Care Corp CurrentSince Apr 21, 2024 Accepting new patients
SC Medical, Inc. CurrentSince Apr 10, 2025 Accepting new patients

Locations

17609 Ventura Blvd
Ste 106
Encino, CA 91316
Phone (818) 774-2457

710 S Central Ave
Ste 330
Glendale, CA 91204
Phone (818) 500-8739

19042 Soledad Canyon Rd
Santa Clarita, CA 91351
Phone (661) 251-6300

27550 Newhall Ranch Rd
Ste 203
Valencia, CA 91355
Phone (661) 251-6300

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1713398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1285489864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19042 SOLEDAD CANYON RD",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "913513362",
            "telephone_number": "661-251-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19042 SOLEDAD CANYON RD",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "913513362",
            "telephone_number": "661-251-6300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17609 Ventura Blvd",
            "address_purpose": "LOCATION",
            "city": "Encino",
            "state": "CA",
            "postal_code": "913163858",
            "country_code": "US",
            "telephone_number": "818-774-2757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUA",
        "first_name": "BETTINA DENNISE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-18",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95028852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canyon Country, CA

Sources for this page

Verify at the official NPI Registry.