Individual provider Active NPI

Angelica De Leon Renteria, N.P.

  • Family Nurse Practitioner
  • Clovis, CA
National Provider Identifier
1336268499
Registry record updated Aug 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP9298 Issued in CA
Practice address
722 Medical Center Dr E Ste 101
Clovis, CA 93611-6810
NPI assigned
Mar 28, 2007
Last updated
Aug 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2019

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 NP9298 CA Primary

Addresses

Primary practice location

722 Medical Center Dr E Ste 101
Clovis, CA 93611-6810

Mailing address

722 Medical Center Dr E Ste 101
Clovis, CA 93611-6810
Phone (559) 297-9500

Other identifiers 1

IdentifierTypeStateIssuer
NP9298OtherCACA NP LIC#

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
I20180501002817 CA Practitioner - Nurse Practitioner 8729251392 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9298CAMDSpeech-Language Pathologist
NP9298CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baz Allergy, Asthma & Sinus Center, Inc. CurrentSince Sep 10, 2018 Accepting new patients
Camarena Health CurrentSince Dec 1, 2021 Accepting new patients
Camarena Health CurrentSince Dec 1, 2021 Accepting new patients
Baz Allergy, Asthma & Sinus Center CurrentSince Sep 10, 2018 Accepting new patients
Baz Allergy, Asthma & Sinus Center, Inc. Current Accepting new patients
Camarena Health Family Current Accepting new patients
Camarena Health PastSince Jan 26, 2022 Accepting new patients

Locations

7471 N Fresno St
Fresno, CA 93720
Phone (559) 436-4500

1560 W Lacey Blvd
Ste 103
Hanford, CA 93230
Phone (559) 582-8500

1415 Badger Flat Rd
Ste A
Los Banos, CA 93635
Phone (209) 710-8684

124 S A St
Madera, CA 93638
Phone (559) 664-4042

740 E Almond Ave
Madera, CA 93637

49169 Road 426
Oakhurst, CA 93644
Phone (559) 642-6724

3000 Floral Ave
Selma, CA 93662
Phone (559) 318-9240

Interoperability endpoints

  • Direct secure messaging: angelica.de.leon.1@25900.direct.athenahealth.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564704000000",
    "number": "1336268499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 MEDICAL CENTER DR E STE 101",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116810",
            "telephone_number": "559-297-9500",
            "fax_number": "559-297-9572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 MEDICAL CENTER DR E STE 101",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LEON RENTERIA",
        "first_name": "ANGELICA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2019-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP9298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA NP LIC#",
            "identifier": "NP9298",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

Verify at the official NPI Registry.