Individual provider Active NPI

Rosa Maria Javier Miranda, N.P.,

  • Acute Care Nurse Practitioner
  • Loma Linda, CA
National Provider Identifier
1437282522
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
374694 Issued in CA
Practice address
11234 Anderson St
Loma Linda, CA 92354-2804
Phone
(909) 558-8570
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 374694 CA Primary

Addresses

Primary practice location

11234 Anderson St
Loma Linda, CA 92354-2804

Mailing address

15740 Oliver St
Moreno Valley, CA 92555-4908
Phone (951) 242-2106

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160620002074 CA Practitioner - Nurse Practitioner 0840581997 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Dec 7, 2016 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients

Locations

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

Interoperability endpoints

  • Direct secure messaging: rjavier8004@direct.llu.edu

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437282522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15740 OLIVER ST",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925554908",
            "telephone_number": "951-242-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVIER MIRANDA",
        "first_name": "ROSA",
        "middle_name": "MARIA",
        "name_prefix": "Miss",
        "credential": "N.P.,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "374694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.