Individual provider Active NPI

Flordelin Yadira Palomino

  • Acute Care Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1356982607
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95012968 Issued in CA
Practice address
445 S Figueroa St FL 31
Los Angeles, CA 90071-1602
Phone
(510) 378-8643
NPI assigned
Oct 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95012968 CA Primary

Addresses

Primary practice location

445 S Figueroa St FL 31
Los Angeles, CA 90071-1602

Mailing address

445 S Figueroa St FL 31
Los Angeles, CA 90071-1602
Phone (510) 378-8643

Other practice location 1

2021 Herndon Ave Ste 101
Clovis, CA 93611-6316
Phone (559) 797-4315

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
I20201006002686 CA Practitioner - Nurse Practitioner 4789011271

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
William R. Shankle MD Inc. CurrentSince Aug 1, 2020 Accepting new patients

Locations

3900 W Coast Hwy
Ste 310
Newport Beach, CA 92663
Phone (949) 478-8858

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": "1570406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1356982607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 S FIGUEROA ST FL 31",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900711602",
            "telephone_number": "510-378-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 S FIGUEROA ST FL 31",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900711602",
            "telephone_number": "510-378-8643"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2021 Herndon Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Clovis",
            "state": "CA",
            "postal_code": "936116316",
            "country_code": "US",
            "telephone_number": "559-797-4315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALOMINO",
        "first_name": "FLORDELIN",
        "middle_name": "YADIRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-07",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95012968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.