Individual provider Active NPI

John Arviola Zaldua, PMHNP

  • Nurse Practitioner
  • Garden Grove, CA
National Provider Identifier
1306557970
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95023516 Issued in CA
Practice address
12141 Brookhurst St Ste 201
Garden Grove, CA 92840-2865
Phone
(657) 261-7140
NPI assigned
Dec 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95023516 CA Primary

Addresses

Primary practice location

12141 Brookhurst St Ste 201
Garden Grove, CA 92840-2865

Mailing address

415 East Avenue I
Lancaster, CA 93535
Phone (661) 522-6770

Other practice location 1

23161 Mill Creek Dr
Laguna Hills, CA 92653-7908
Phone (949) 264-5350

Other practice location 2

415 East Avenue I
Lancaster, CA 93535
Phone (661) 522-6770

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
I20230223002687 CA Practitioner - Nurse Practitioner 4284007113 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95023516CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Telecare Corporation CurrentSince Feb 1, 2023 Accepting new patients
Telecare Corporation Current Accepting new patients
Telecare Corporation CurrentSince Feb 1, 2023 Accepting new patients
Telecare Corporation CurrentSince Feb 4, 2024 Accepting new patients

Locations

1080 Marina Village Pkwy
Ste 100
Alameda, CA 94501
Phone (510) 306-5660

12141 Brookhurst St
Ste 201
Garden Grove, CA 92840
Phone (657) 261-7140

12141 Brookhurst St
Garden Grove, CA 92840
Phone (714) 296-1934

23161 Mill Creek Dr
Ste 230
Laguna Hills, CA 92653
Phone (949) 264-5350

2020 Iowa Ave
Riverside, CA 92507
Phone (951) 580-1026

2100 N Broadway
Ste 101
Santa Ana, CA 92706
Phone (714) 245-6881

14149 Bucher Ave
Sylmar, CA 91342
Phone (747) 999-4232

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": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1306557970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 EAST AVENUE I",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "93535",
            "telephone_number": "661-522-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12141 BROOKHURST ST STE 201",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928402865",
            "telephone_number": "657-261-7140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23161 Mill Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Laguna Hills",
            "state": "CA",
            "postal_code": "926537908",
            "country_code": "US",
            "telephone_number": "949-264-5350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "415 East Avenue I",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "CA",
            "postal_code": "93535",
            "country_code": "US",
            "telephone_number": "661-522-6770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZALDUA",
        "first_name": "JOHN",
        "middle_name": "ARVIOLA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-05",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95023516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.