Active NPI
Maria Cecilia Jamito Colli, NP
- Family Nurse Practitioner
- San Diego, CA
National Provider Identifier
1356852206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95007076
- Practice address
- 6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715 - Phone
- (858) 859-1188
- NPI assigned
- Oct 18, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95007076 | CA | Primary |
Addresses
Primary practice location
6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715
Mailing address
6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715
Phone (858) 859-1188
Other names 1
- Maria Jamito Colli
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95007076 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Mobile Wound Care | Single Specialty | Current | Accepting new patients |
| Perpetual Wound Rescue | Single Specialty | Current | Accepting new patients |
Locations
1100 E Orangethorpe Ave
Ste 200R
Anaheim, CA 92801
Phone (714) 273-7672
1100 E Orangethorpe Ave
Ste 252K
Anaheim, CA 92801
Phone (562) 388-8458
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": "1508284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667260800000",
"number": "1356852206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6195 LUSK BLVD STE 250",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921213715",
"telephone_number": "858-859-1188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6195 LUSK BLVD STE 250",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921213715",
"telephone_number": "858-859-1188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLI",
"first_name": "MARIA CECILIA",
"middle_name": "JAMITO",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-18",
"last_updated": "2022-11-01",
"certification_date": "2022-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95007076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARIA",
"last_name": "COLLI",
"middle_name": "JAMITO",
"credential": "NP",
"code": "5",
"type": "Other Name"
}
]
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.