Individual provider Active NPI

Michael Angello Negron, DNP, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1306420450
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN-3282 Issued in HI
Practice address
8875 Aero Dr
San Diego, CA 92123-2251
Phone
(619) 400-5000
NPI assigned
May 5, 2021
Last updated
Jan 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN-3282 HI Primary
Registered Nurse 163W00000X RN-100845 HI
Registered Nurse 163W00000X 795770 CA

Addresses

Primary practice location

8875 Aero Dr
San Diego, CA 92123-2251

Mailing address

3350 La Jolla Village Dr
San Diego, CA 92161-0002
Phone (858) 552-8585

Other names 1

  • Michael Angello Negron Vidaurre(Maiden Name) Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
795770CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1306420450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610002",
            "telephone_number": "858-552-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8875 AERO DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232251",
            "telephone_number": "619-400-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEGRON",
        "first_name": "MICHAEL",
        "middle_name": "ANGELLO",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-05",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "HI",
            "license": "APRN-3282",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "HI",
            "license": "RN-100845",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "795770",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "NEGRON VIDAURRE(MAIDEN NAME)",
            "middle_name": "ANGELLO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.