Dorothy A Tagan, RN CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

20274 Issued in CA

Practice address

30210 Rancho Viejo Rd
Suite a
San Juan Capistrano, CA 92675-1574

Phone

(949) 493-7337

Fax

(949) 493-1418

NPI assigned

Sep 2, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner, Registered Nurse

State licenses

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

{
    "created_epoch": "1314921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314921600000",
    "number": "1295016368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30210 RANCHO VIEJO RD",
            "address_2": "SUITE A",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751574",
            "telephone_number": "949-493-7337",
            "fax_number": "949-493-1418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30210 RANCHO VIEJO RD",
            "address_2": "SUITE A",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751574",
            "telephone_number": "949-493-7337",
            "fax_number": "949-493-1418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGAN",
        "first_name": "DOROTHY",
        "middle_name": "A",
        "credential": "RN CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-02",
        "last_updated": "2011-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "304991",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "20274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Nurse Practitioner in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; 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.