Czarina Lim Perello, MSN-FNP
Individual provider Active NPI Family Nurse Practitioner · Needles, CA
NPI 1306188958 · NPPES record last updated Jul 1, 2021
Key facts
- NPI
- 1306188958
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 22692 (CA)
- Practice address
- 1401 Bailey Avenue
Needles, CA 92363 - Phone
- (909) 223-1138
- NPI assigned
- Mar 21, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170220001903 | CA | Practitioner - Nurse Practitioner | 7012212632 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22692 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri-State Community Healthcare Center | Current |
Accepting new patients |
Locations
11888 Bartlett Ave
Adelanto, CA 92301
Phone (760) 530-9944
11499 Bartlett Ave
Adelanto, CA 92301
Phone (760) 444-4258
820 W Broadway St
Needles, CA 92363
Phone (730) 326-0222
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 22692 | CA | Yes |
Addresses
Primary practice location
1401 Bailey Avenue
Needles, CA 92363
Mailing address
1401 Bailey Avenue
Needles, CA 92363
Phone (909) 223-1138
Other providers in Needles, CA
- Needles Hospital, Inc
- Needles Medical Management Center Inc
- Pacific Clinics
- Mistydae Paget
- Juan Carlos Pequeno
- Jason Dean Phillips
- Premier Emergency Physicians of California Medical Group PC
- Principal-Needles Inc
- Principal-Needles Inc
- Martin Robert Reid
All providers in Needles, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.