Individual provider Active NPI

Lashara Renita Maea, FNP

  • Family Nurse Practitioner
  • Indio, CA
National Provider Identifier
1295551851
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95032199 Issued in CA
Practice address
82013 Dr Carreon Blvd Ste G
Indio, CA 92201-5832
Phone
(760) 775-9500
NPI assigned
Nov 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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 95032199 CA Primary

Addresses

Primary practice location

82013 Dr Carreon Blvd Ste G
Indio, CA 92201-5832

Mailing address

PO Box 320
Twentynine Palms, CA 92277-0269

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
I20250123001789 CA Practitioner - Nurse Practitioner 8820527625 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95032199CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minghsun Liu, M.D., PC CurrentSince Jan 20, 2025 Accepting new patients
Wea Ca PC Past Accepting new patients

Locations

11103 Venice Blvd
Los Angeles, CA 90034
Phone (310) 734-8526

200 S Park Rd
Ste 200
Hollywood, FL 33021
Phone (866) 986-2263

Interoperability endpoints

  • Direct secure messaging: lashara.maea.1@28348.direct.athenahealth.com

Organizations & group practices 2

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": "1732752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1295551851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 320",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "922770269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82013 DR CARREON BLVD STE G",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015832",
            "telephone_number": "760-775-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAEA",
        "first_name": "LASHARA",
        "middle_name": "RENITA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95032199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

Verify at the official NPI Registry.