Nicolas Phetniranh Sengdara, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95009671 Issued in CA

Practice address

25272 Marguerite Pkwy
Mission Viejo, CA 92692-2901

Phone

(949) 581-9120

NPI assigned

Aug 8, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1386123511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25272 MARGUERITE PKWY",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926922901",
            "telephone_number": "949-581-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25272 MARGUERITE PKWY",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926922901",
            "telephone_number": "949-581-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENGDARA",
        "first_name": "NICOLAS",
        "middle_name": "PHETNIRANH",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-08",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Mark Seferian, D.C.
• Frances J. Segal, M.D.
• Bruce Seligsohn, M.D.
• Donna Coyle Semione, COTA
• David D. Semrau, D.D.S.
• Senior Home Advocates
• Senior Ride & Homecare Inc. (OC Homecare Services)
• Stephanie Seo, PHARMD
• Denisse Fabiola Serafin, M.S. (C)
• Serenity Health SS Limited Liability Company

• Family Nurse Practitioner in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.