Monica Avila, NP
Individual provider Active NPI Pediatric Nurse Practitioner · South Gate, CA
NPI 1447069943 · NPPES record last updated Aug 15, 2025
Key facts
- NPI
- 1447069943
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 95033674 (CA)
- Practice address
- 5831 Firestone Blvd
South Gate, CA 90280-3718 - Phone
- (310) 919-2320
- NPI assigned
- Dec 31, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251231003813 | CA | Order and Referring Only - Pediatric Medicine |
1951897636 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95033674 | CA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairway Children'S Medical Group | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 95033674 | CA | Yes |
Addresses
Primary practice location
5831 Firestone Blvd
South Gate, CA 90280-3718
Mailing address
5831 Firestone Blvd
South Gate, CA 90280-3718
Phone (310) 919-2320
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All providers in South Gate, CA · Pediatric Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.