Individual provider Active NPI

Eri Minagawa, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Gardena, CA
National Provider Identifier
1346025210
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95026911 Issued in CA
Practice address
1225 W 190TH St Ste 280
Gardena, CA 90248-4305
Phone
(877) 515-8113
NPI assigned
Aug 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95026911 CA Primary

Addresses

Primary practice location

1225 W 190TH St Ste 280
Gardena, CA 90248-4305

Mailing address

11642 Victory Blvd Unit 2018
North Hollywood, CA 91606-3514
Phone (818) 301-3018

Other practice location 1

11642 Victory Blvd Unit 2018
North Hollywood, CA 91606-3514
Phone (818) 301-3018

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
I20240228004439 CA Practitioner - Nurse Practitioner 9739524869 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ehab Yacoub MD IncGroup PAC ID 5092099523, 179 clinicians

Practice addresses (Care Compare)

915 Highland Pointe Dr
Suite 250
Roseville, CA 95678-5421
Phone (877) 515-8113

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Mind Health Inc. CurrentSince Feb 10, 2026 Accepting new patients
Ehab Yacoub MD Inc. CurrentSince Feb 13, 2024 Accepting new patients

Locations

1370 Valley Vista Dr
Ste 200
Diamond Bar, CA 91765
Phone (310) 981-8227

1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113

17075 Devonshire St
Ste 204
Northridge, CA 91325
Phone (818) 368-8929

915 Highland Pointe Dr
Ste 250
Roseville, CA 95678
Phone (530) 713-4306

6851 Lennox Ave
Ste 405
Van Nuys, CA 91405
Phone (866) 557-7924

14541 Delano St
Van Nuys, CA 91411
Phone (310) 515-8113

8413 Fallbrook Ave
#200
West Hills, CA 91304
Phone (866) 557-7924

Organizations & group practices 2

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": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1346025210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11642 VICTORY BLVD UNIT 2018",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063514",
            "telephone_number": "818-301-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 W 190TH ST STE 280",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484305",
            "telephone_number": "877-515-8113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11642 Victory Blvd Unit 2018",
            "address_purpose": "LOCATION",
            "city": "North Hollywood",
            "state": "CA",
            "postal_code": "916063514",
            "country_code": "US",
            "telephone_number": "818-301-3018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINAGAWA",
        "first_name": "ERI",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-29",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95026911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.