Individual provider Active NPI

Enrica Moreno Mabulay

  • Specialist
  • Encino, CA
National Provider Identifier
1407713506
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
250102243 Issued in CA
Practice address
16500 Ventura Blvd Ste 414
Encino, CA 91436-5050
Phone
(818) 788-1003
NPI assigned
Jan 8, 2026
Last updated
Jan 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 250102243 CA Primary

Addresses

Primary practice location

16500 Ventura Blvd Ste 414
Encino, CA 91436-5050

Mailing address

14031 Astoria St Unit 106
Sylmar, CA 91342-2984
Phone (701) 797-7161

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
250102243CAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1767830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1407713506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14031 ASTORIA ST UNIT 106",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913422984",
            "telephone_number": "701-797-7161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16500 VENTURA BLVD STE 414",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914365050",
            "telephone_number": "818-788-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABULAY",
        "first_name": "ENRICA",
        "middle_name": "MORENO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-08",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "250102243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2026; 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.