Active NPI
Pauline H Nguyen, RNP
- Nurse Practitioner
- Simi Valley, CA
National Provider Identifier
1386078194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 11288
- Practice address
- 1177 Roadrunner Way
Simi Valley, CA 93065-3159 - Phone
- (805) 520-1577
- Fax
- (805) 520-8091
- NPI assigned
- Aug 28, 2013
- Last updated
- Aug 28, 2013
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 11288 | CA | Primary |
Addresses
Primary practice location
1177 Roadrunner Way
Simi Valley, CA 93065-3159
Mailing address
1177 Roadrunner Way
Simi Valley, CA 93065-3159
Phone (805) 520-1577
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11288 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377648000000",
"number": "1386078194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1177 ROADRUNNER WAY",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930653159",
"telephone_number": "805-520-1577",
"fax_number": "805-520-8091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1177 ROADRUNNER WAY",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930653159",
"telephone_number": "805-520-1577",
"fax_number": "805-520-8091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "PAULINE",
"middle_name": "H",
"credential": "RNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-28",
"last_updated": "2013-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "11288",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Simi Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.