Pricilla Adelia Requena

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

123765 Issued in CA

Practice address

11118 S Osage Ave Apt 7
Inglewood, CA 90304-2967

Phone

(424) 581-2844

Fax

(424) 581-2844

NPI assigned

Sep 22, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1417628173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11118 S OSAGE AVE APT 7",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903042967",
            "telephone_number": "424-581-2844",
            "fax_number": "424-581-2844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11118 S OSAGE AVE APT 7",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903042967",
            "telephone_number": "424-581-2844",
            "fax_number": "424-581-2844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REQUENA",
        "first_name": "PRICILLA",
        "middle_name": "ADELIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-22",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "CA",
            "license": "NON",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "CA",
            "license": "123765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F1168310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gracen Reed, ACSW
• Regent Medical Group Laboratory
• Releford Foot and Ankle Institute
• Bill J. Releford, DPM
• Reliable Advanced Clinicians Inc
• Antonio Reyes Jr.
• Ashleylauren Reyes, LMFT
• Jacobo Machuca Reyes, BA, CADCIII
• Jose Antonio Reyes
• Katherine Brittany Reyes, BA

• Nurse's Aide in Inglewood, CA
• Providers in Inglewood, CA by specialty
• Nurse's Aide in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.