Tina Donaldson, RN, NP

Individual provider Active NPI Basic Emergency Medical Technician · Winnetka, CA

NPI 1376934174 · NPPES record last updated Sep 30, 2015

Key facts

NPI
1376934174
Entity type
Individual (NPI type 1)
Primary specialty
Basic Emergency Medical Technician 146N00000X
License
95001375 (CA)
Practice address
20800 Sherman Way
Winnetka, CA 91306-2707
Phone
(818) 715-9031
NPI assigned
Feb 16, 2015
Sex
Female
Sole proprietor
No

Organizations & group practices 20

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Northeast Valley Health Corporation (77 clinicians)
El Proyecto del Barrio Inc (27 clinicians)

Practice addresses (Care Compare)

12756 Van Nuys Blvd
Pacoima, CA 91331-1626
Phone (818) 896-0531

14624 Sherman Way
FL 6
Van Nuys, CA 91405-2241
Phone (818) 988-6335

1600 San Fernando Rd
San Fernando, CA 91340-3115
Phone (818) 365-8086

20800 Sherman Way
Canoga Park, CA 91306-2707
Phone (818) 883-2273

7107 Remmet Ave
Canoga Park, CA 91303-2016
Phone (818) 340-3570

8902 Woodman Ave
Arleta, CA 91331-6401
Phone (818) 830-7080

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160420002271 CA Practitioner - Nurse Practitioner 7416255633 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
El Proyecto del Barrio, Inc. Current
since Mar 13, 2016
Accepting new patients
Northeast Valley Health Corporation Current
since Nov 4, 2017
Accepting new patients
Northeast Valley Health Corporation Current Accepting new patients
El Proyecto del Barrio, Inc. Current Accepting new patients
Northeast Valley Health Corporation Current
since Nov 4, 2017
Accepting new patients
El Proyecto del Barrio, Inc. Current
since Mar 13, 2016
Accepting new patients

Locations

8902 Woodman Ave
Arleta, CA 91331
Phone (818) 830-7033

7843 Lankershim Blvd
North Hollywood, CA 91605
Phone (818) 765-8656

1172 N Maclay Ave
San Fernando, CA 91340
Phone (818) 898-1388

1600 San Fernando Rd
San Fernando, CA 91340
Phone (818) 365-8086

20800 Sherman Way
Winnetka, CA 91306
Phone (818) 883-2273

Interoperability endpoints

  • Direct secure messaging: tdonaldson@exer.direct.codonix.com
  • Direct secure messaging: tina.donaldson.p1@direct.nevhc.nextgenshare.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X 95001375 CA Yes

Addresses

Primary practice location

20800 Sherman Way
Winnetka, CA 91306-2707

Mailing address

20800 Sherman Way
El Proyecto del Barrio
Winnetka, CA 91306-2707
Phone (818) 715-9031

Other providers in Winnetka, CA

All providers in Winnetka, CA · Basic Emergency Medical Technician in California

Sources for this page

Verify at the official NPI Registry.