Individual provider Active NPI

Rebecca Louise Namdaran, FNP-C

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1407371578
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95006861 Issued in CA
Practice address
1520 San Pablo St Ste 1000
Los Angeles, CA 90033-5312
Phone
(323) 442-5100
NPI assigned
Aug 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 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 0024175014 VA
Family Nurse Practitioner 363LF0000X 95006861 CA Primary

Addresses

Primary practice location

1520 San Pablo St Ste 1000
Los Angeles, CA 90033-5312

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-5100

Other identifiers 1

IdentifierTypeStateIssuer
0024175014OtherVALICENSED NURSE PRACTITIONER

Other names 1

  • Rebecca Louise Rios Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190114002825 CA Practitioner - Nurse Practitioner 5294071171 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95006861CAMDFamily Nurse Practitioner
0024175014VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Aug 1, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 26, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Usc Care Medical Group, Inc CurrentSince Aug 1, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 26, 2024 Accepting new patients
Scripps Health Current Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

1450 San Pablo St
Ste 3000
Los Angeles, CA 90033
Phone (323) 442-5250

1520 San Pablo St
Ste 1000
Los Angeles, CA 90033
Phone (626) 457-5839

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

Interoperability endpoints

  • Direct secure messaging: rrios159807@scrippshlth.medalliesdirect.net

Organizations & group practices 6

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": "1502236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1407371578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO ST STE 1000",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335312",
            "telephone_number": "323-442-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMDARAN",
        "first_name": "REBECCA",
        "middle_name": "LOUISE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024175014",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED NURSE PRACTITIONER",
            "identifier": "0024175014",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "RIOS",
            "middle_name": "LOUISE",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.