Active NPI
Betty Leong Tabora, RN
- Psychiatric/Mental Health Registered Nurse
- Granada Hills, CA
National Provider Identifier
1356468524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Registered Nurse
- License
- 289596
- Practice address
- 10605 Balboa Blvd
Suite 100
Granada Hills, CA 91344-6342 - Phone
- (818) 832-2415
- NPI assigned
- Mar 23, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 289596 | CA | Primary |
Addresses
Primary practice location
10605 Balboa Blvd
Suite 100
Granada Hills, CA 91344-6342
Mailing address
2379 Nalin Dr
Los Angeles, CA 90077-1806
Phone (310) 476-2632
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 289596 | CA | MD | Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356468524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2379 NALIN DR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900771806",
"telephone_number": "310-476-2632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10605 BALBOA BLVD",
"address_2": "SUITE 100",
"city": "GRANADA HILLS",
"state": "CA",
"postal_code": "913446342",
"telephone_number": "818-832-2415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABORA",
"first_name": "BETTY",
"middle_name": "LEONG",
"name_prefix": "Dr.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "CA",
"license": "289596",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Granada Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.