Active NPI
Monique Vaillancourt, MSN, NP
- Primary Care Nurse Practitioner
- Los Angeles, CA
National Provider Identifier
1407974223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- RNP11874
- Practice address
- 221 Westwood PLZ
Los Angeles, CA 90095-1703 - Phone
- (310) 794-7919
- NPI assigned
- Mar 27, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | RNP11874 | CA | Primary |
Addresses
Primary practice location
221 Westwood PLZ
Los Angeles, CA 90095-1703
Mailing address
221 Westwood PLZ
Los Angeles, CA 90095-1703
Phone (310) 794-7919
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RNP11874 | CA | MD | Primary Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407974223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "221 WESTWOOD PLZ",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900951703",
"telephone_number": "310-794-7919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 WESTWOOD PLZ",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900951703",
"telephone_number": "310-794-7919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAILLANCOURT",
"first_name": "MONIQUE",
"credential": "MSN, NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "CA",
"license": "RNP11874",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.