Individual provider Active NPI

Susan Cienfuegos Reid, FNP

  • Family Nurse Practitioner
  • San Fernando, CA
National Provider Identifier
1386116077
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95014309 Issued in CA
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

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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 Former name

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

LicenseStateTypeSpecialty
219932AZMDFamily Nurse Practitioner
95014309CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
San Fernando Community Hospital CurrentSince Sep 15, 2024 Accepting new patients
San Fernando Community Health Center PastSince Sep 15, 2024 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

  • FHIR API: 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.

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.

Verify at the official NPI Registry.