Diana Estela Menjivar

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

NP95013855 Issued in CA

Practice address

1117 N Bonnie Beach PL
Los Angeles, CA 90063-1243

Phone

(213) 434-6910

NPI assigned

Aug 23, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1306565320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 N BONNIE BEACH PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900631243",
            "telephone_number": "213-434-6910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 N BONNIE BEACH PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900631243",
            "telephone_number": "213-434-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENJIVAR",
        "first_name": "DIANA",
        "middle_name": "ESTELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "NP95013855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "telehealth",
            "affiliation": "N",
            "endpointDescription": "telehealth",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "desktop",
            "address_1": "1117 N Bonnie Beach Pl",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900631243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gerthie Menier, NP
• Roslyn Menitoff, LCSW
• Jessica Liseth Menjivar Cruz
• Jennifer Stephanie Menjivar-Lopez, MD
• Bertha Janet Menjivar, LCSW 80277
• Genesis Menjivar
• Janeri Fabiola Menjivar
• Karla Iliana Menjivar, FNP
• Silvia Menjivar
• William Menjivar

• Gerontology Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Gerontology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.