Agatha J Covarrubias, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95002944 Issued in CA

Practice address

3105 McHenry Ave Ste 101
Modesto, CA 95350-1439

Phone

(209) 575-2700

NPI assigned

Oct 27, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Agatha I John Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ajohn343439@hisp.ehr.sutterhealth.org

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.

• La Laser Center PC, a Professional Medical Corporation

  • Non-Pharmacy Dispensing Site
  • Turlock, CA
  • NPI 1356974059
  NPD (past)

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

{
    "created_epoch": "1445904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1417329640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 M ST",
            "city": "PATTERSON",
            "state": "CA",
            "postal_code": "953632121",
            "telephone_number": "205-586-1983",
            "fax_number": "209-874-3896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 MCHENRY AVE STE 101",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953501439",
            "telephone_number": "209-575-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 E Orangeburg Ave Ste A2",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953553399",
            "country_code": "US",
            "telephone_number": "209-846-0321",
            "fax_number": "209-622-0956",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "324 F St",
            "address_purpose": "LOCATION",
            "city": "Waterford",
            "state": "CA",
            "postal_code": "953869013",
            "country_code": "US",
            "telephone_number": "209-874-1292",
            "fax_number": "209-874-3896",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1108 Ward Ave Bldg A Ste 1",
            "address_purpose": "LOCATION",
            "city": "PATTERSON",
            "state": "CA",
            "postal_code": "95363",
            "country_code": "US",
            "telephone_number": "209-892-1300",
            "fax_number": "209-780-4141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COVARRUBIAS",
        "first_name": "AGATHA",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-27",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A70897",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "95069913",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A76562",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "WA",
            "license": "60579117",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95002944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093183261",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AGATHA",
            "last_name": "JOHN",
            "middle_name": "I",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• County of Stanislaus Health Services Agency
• Anthony Court
• Jessica Courtney
• Caress Cousins
• Sarai Stern Coutin, MD
• Brenda Covarrubias
• Dolores R Covarrubias, LCSW
• Covenant Care California Inc
• Covenant Care California, LLC
• Covenant Care California, LLC

• All providers in Modesto, CA
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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.

Verify at the official NPI Registry.