Individual provider Active NPI

Anthony Familian, SSD

  • Home Health Aide
  • Lake Forest, CA
National Provider Identifier
1386890986
Registry record updated Aug 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
C2984157 Issued in CA
Practice address
26305 Lily GLN
Lake Forest, CA 92630-7258
Phone
(949) 500-1105
NPI assigned
Aug 14, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X C2984157 CA Primary

Addresses

Primary practice location

26305 Lily GLN
Lake Forest, CA 92630-7258

Mailing address

26305 Lily GLN
Lake Forest, CA 92630-7258
Phone (949) 500-1105

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

LicenseStateTypeSpecialty
C2984157CAMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218672000000",
    "number": "1386890986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26305 LILY GLN",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926307258",
            "telephone_number": "949-500-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26305 LILY GLN",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926307258",
            "telephone_number": "949-500-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAMILIAN",
        "first_name": "ANTHONY",
        "credential": "SSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-14",
        "last_updated": "2008-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "CA",
            "license": "C2984157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; 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.