Active NPI
Susan Cienfuegos Reid, FNP
- Family Nurse Practitioner
- San Fernando, CA
National Provider Identifier
1386116077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95014309
- Practice address
- 732 Mott St Ste 100
San Fernando, CA 91340-4240 - Phone
- (818) 963-5690
- Fax
- (818) 365-0726
- NPI assigned
- Dec 19, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 219932 | AZ | |
| Family Nurse Practitioner | 363LF0000X | 95014309 | CA | Primary |
Addresses
Primary practice location
732 Mott St Ste 100
San Fernando, CA 91340-4240
Mailing address
14355 Foothill Blvd Unit 6
Sylmar, CA 91342-8003
Other names 1
- Susan Veronica Cienfuegos
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 219932 | AZ | MD | Family Nurse Practitioner |
| 95014309 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Fernando Community Hospital | Current | Accepting new patients | |
| San Fernando Community Health Center | Past | Accepting new patients |
Locations
732 Mott St
Ste 100
San Fernando, CA 91340
Phone (818) 365-5059
732 Mott St
Ste 100110
San Fernando, CA 91340
Phone (818) 963-5690
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/HFDBCA
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.
-
dba San Fernando Community Health Center
- Primary Care Clinic/Center
- San Fernando, CA
- NPI 1245669555
-
- Clinic/Center
- San Fernando, CA
- NPI 1093151821
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726185600000",
"number": "1386116077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14355 FOOTHILL BLVD UNIT 6",
"city": "SYLMAR",
"state": "CA",
"postal_code": "913428003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "732 MOTT ST STE 100",
"city": "SAN FERNANDO",
"state": "CA",
"postal_code": "913404240",
"telephone_number": "818-963-5690",
"fax_number": "818-365-0726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REID",
"first_name": "SUSAN",
"middle_name": "CIENFUEGOS",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-19",
"last_updated": "2024-09-13",
"certification_date": "2024-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AZ",
"license": "219932",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95014309",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "CIENFUEGOS",
"middle_name": "VERONICA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in San Fernando, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.