Individual provider Active NPI

Emily Angelica Agito Dela Rosa, FNP-BC

  • Nurse Practitioner
  • Riverside, CA
National Provider Identifier
1336463652
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP20571 Issued in CA
Practice address
4361 Latham St Ste 270
Riverside, CA 92501-4332
Phone
(951) 774-0064
NPI assigned
Mar 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2019

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 NP20571 CA Primary

Addresses

Primary practice location

4361 Latham St Ste 270
Riverside, CA 92501-4332

Mailing address

8390 Hermosa Ave Apt G
Rancho Cucamonga, CA 91730-6928
Phone (714) 803-8960

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
I20120321000418 CA Practitioner - Nurse Practitioner 3173655248 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nightingale Clinical Care, PC CurrentSince Mar 1, 2020 Accepting new patients

Locations

902 Bear Mountain Blvd
Arvin, CA 93203
Phone (209) 543-1720

2438 N Ponderosa Dr
Ste C101
Camarillo, CA 93010
Phone (559) 664-9252

4445 Riverside Dr
Chino, CA 91710
Phone (760) 202-3491

510 E North Way
Dinuba, CA 93618
Phone (209) 473-2294

11690 San Pablo Ave
El Cerrito, CA 94530

501 E Almond Ave
Madera, CA 93637
Phone (559) 664-9252

3001 Health Care Way
Ste 102
Modesto, CA 95356
Phone (559) 664-9255

78030 Wildcat Dr
Ste 101
Palm Desert, CA 92211
Phone (908) 845-4494

320 James Way
Ste 100
Pismo Beach, CA 93449
Phone (209) 827-3973

4361 Latham St
Ste 270
Riverside, CA 92501
Phone (303) 876-2930

3 Rossi Cir
Unit A
Salinas, CA 93907
Phone (760) 371-7506

9850 Carmel Mountain Rd
San Diego, CA 92129
Phone (805) 764-0171

555 W Benjamin Holt Dr
Ste 200
Stockton, CA 95207
Phone (661) 725-1370

30730 Russell Ranch Rd
Ste A
Westlake Village, CA 91362
Phone (805) 643-7549

Organizations & group practices 1

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": "1268611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1336463652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8390 HERMOSA AVE APT G",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917306928",
            "telephone_number": "714-803-8960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4361 LATHAM ST STE 270",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014332",
            "telephone_number": "951-774-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELA ROSA",
        "first_name": "EMILY ANGELICA",
        "middle_name": "AGITO",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-15",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP20571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.