Jennifer Destreza Ryan, MSN, AGNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

95012280 Issued in CA

Practice address

5315 Torrance Blvd
Torrance, CA 90503-4011

Phone

(800) 535-8446

NPI assigned

Aug 10, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jryan1154977@oc.providencedirect.org

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.

• Supportive Care Specialists

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1518705771
  Medicare reassignment NPD
• Goldencast Medical Corporation

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1952550097
  Medicare reassignment

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

{
    "created_epoch": "1565395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565395200000",
    "number": "1447806021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3821 W 184TH PL",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905044813",
            "telephone_number": "310-634-9739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5315 TORRANCE BLVD",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034011",
            "telephone_number": "800-535-8446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3821 W 184th Pl",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905044813",
            "country_code": "US",
            "telephone_number": "310-634-9739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "JENNIFER",
        "middle_name": "DESTREZA",
        "credential": "MSN, AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-10",
        "last_updated": "2019-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95012280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Ruther
• Scott Edward Ruther, PT
• Lydia Ruvalcaba, M.S., BCBA
• Ruzer Medical Services, Inc.
• Christine Michelle Ryan, LCSW
• Matthew William Ryan, F.N.P.
• Timothy James Ryan, M.D.
• Nancy Kyung Ryder, AC
• Glenda Ryles
• Shane P Ryley

• Gerontology Nurse Practitioner in Torrance, CA
• Providers in Torrance, CA by specialty
• Gerontology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.