Traci Akiko Eguchi, N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

21966 Issued in CA

Practice address

1821 Wilshire Blvd Ste 100
Santa Monica, CA 90403-5627

Phone

(310) 575-3100

Fax

(310) 575-3102

NPI assigned

May 10, 2012

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)

Enrolled

Credentials

Nurse Practitioner

Interoperability endpoints

• Direct secure messaging: teguchi671775@oc.providencedirect.org

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

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1356600423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 10TH ST",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902666101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 WILSHIRE BLVD STE 100",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035627",
            "telephone_number": "310-575-3100",
            "fax_number": "310-575-3102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2143 S Sepulveda Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900255733",
            "country_code": "US",
            "telephone_number": "310-575-3100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGUCHI",
        "first_name": "TRACI",
        "middle_name": "AKIKO",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-10",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "21966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "teguchi671775@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1821 Wilshire Blvd Ste 100",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904035627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Richard Leon Edwards IV, D.D.S
• Edwin C. Amos, MD, Inc
• Edwin C. Glass, M.D., Inc.
• Rebecca Egan, DPT
• Jeffrey Michael Egler, M.D.
• Kevin M Ehrhart, M.D.
• Amanda Ehrman, AMFT
• Dyana Eidelstein, DMD
• Richard Neil Eidinger, MD
• Thomas M. Einstein, M.D.

• Adult Health Nurse Practitioner in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.