Individual provider Active NPI

Proserfina Mendoza Manalad-Garcia

  • Psychiatric/Mental Health Registered Nurse
  • Sylmar, CA
National Provider Identifier
1427529296
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
733690 Issued in CA
Practice address
13501 Fenton Ave
Sylmar, CA 91342-3066
Phone
(323) 203-6033
NPI assigned
Dec 5, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 733690 CA
Psychiatric/Mental Health Registered Nurse 163WP0808X 733690 CA Primary

Addresses

Primary practice location

13501 Fenton Ave
Sylmar, CA 91342-3066

Mailing address

13501 Fenton Ave
Sylmar, CA 91342-3066

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
733690CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1427529296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13501 FENTON AVE",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913423066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13501 FENTON AVE",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913423066",
            "telephone_number": "323-203-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANALAD-GARCIA",
        "first_name": "PROSERFINA",
        "middle_name": "MENDOZA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-05",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "733690",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "733690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; 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.