Individual provider Active NPI

Irene Seruya Agutu Oduor, REGISTERED NURSE

  • Low-Risk Neonatal Registered Nurse
  • Rancho Cucamonga, CA
National Provider Identifier
1447088406
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Low-Risk Neonatal Registered NurseTaxonomy code 163WN0003X
License
651191 Issued in CA
Practice address
7819 Danner CT
Rancho Cucamonga, CA 91730-6866
Phone
(909) 528-2321
NPI assigned
Jul 22, 2024
Last updated
Jul 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 651191 CA
Low-Risk Neonatal Registered Nurse 163WN0003X 651191 CA Primary
Pediatric Registered Nurse 163WP0200X 651191 CA
Perinatal Registered Nurse 163WP1700X 651191 CA

Addresses

Primary practice location

7819 Danner CT
Rancho Cucamonga, CA 91730-6866

Mailing address

7819 Danner CT
Rancho Cucamonga, CA 91730-6866
Phone (909) 528-2321

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
651191CAMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1447088406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7819 DANNER CT",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917306866",
            "telephone_number": "909-528-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7819 DANNER CT",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917306866",
            "telephone_number": "909-528-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUOR",
        "first_name": "IRENE",
        "middle_name": "SERUYA AGUTU",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "CA",
            "license": "651191",
            "primary": false
        },
        {
            "code": "163WN0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal, Low-Risk",
            "state": "CA",
            "license": "651191",
            "primary": true
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "CA",
            "license": "651191",
            "primary": false
        },
        {
            "code": "163WP1700X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Perinatal",
            "state": "CA",
            "license": "651191",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.