Individual provider Active NPI

Phoebe Claire Tabaranza, NP-C

  • Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1295474468
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95020187 Issued in CA
Practice address
9095 Rio San Diego Dr Ste 425
San Diego, CA 92108-1679
Phone
(858) 455-5524
Fax
(858) 587-9377
NPI assigned
Jun 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X NP95020187 CA
Nurse Practitioner 363L00000X 95020187 CA Primary

Addresses

Primary practice location

9095 Rio San Diego Dr Ste 425
San Diego, CA 92108-1679

Mailing address

2492 Antlers Way
San Marcos, CA 92078-2140
Phone (201) 919-1683

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
I20220726002655 CA Practitioner - Nurse Practitioner 4880076694 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95020187CAMDGynecologic Oncology Physician
95020187CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Coast Gynecologic Oncology, Inc CurrentSince May 26, 2024 Accepting new patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

9850 Genesee Ave
Ste 320
La Jolla, CA 92037
Phone (858) 864-9800

5030 Camino de la Siesta
Ste 204
San Diego, CA 92108
Phone (858) 455-5524

9095 Rio San Diego Dr
Ste 425
San Diego, CA 92108
Phone 8584555524 ext. 205

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1295474468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2492 ANTLERS WAY",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782140",
            "telephone_number": "201-919-1683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9095 RIO SAN DIEGO DR STE 425",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081679",
            "telephone_number": "858-455-5524",
            "fax_number": "858-587-9377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABARANZA",
        "first_name": "PHOEBE",
        "middle_name": "CLAIRE",
        "name_prefix": "Miss",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-03",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "CA",
            "license": "NP95020187",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95020187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.