Individual provider Active NPI

Sarrah Jane Perez Cosico, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Glendale, CA
National Provider Identifier
1457005928
Registry record updated Jan 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95022073 Issued in CA
Practice address
710 S Central Ave Ste 340
Glendale, CA 91204-4647
Phone
(818) 500-8739
Fax
(818) 500-0957
NPI assigned
Feb 4, 2022
Last updated
Jan 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95022073 CA Primary

Addresses

Primary practice location

710 S Central Ave Ste 340
Glendale, CA 91204-4647

Mailing address

710 S Central Ave Ste 340
Glendale, CA 91204-4647
Phone (818) 500-8739

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
95022073CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
California Primary Health Care Corp CurrentSince Mar 1, 2023 Accepting new patients

Locations

710 S Central Ave
Ste 330
Glendale, CA 91204
Phone (818) 263-5737

710 S Central Ave
Ste 340
Glendale, CA 91204
Phone (818) 409-0060

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705190400000",
    "number": "1457005928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 S CENTRAL AVE STE 340",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044647",
            "telephone_number": "818-500-8739",
            "fax_number": "818-500-0957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 S CENTRAL AVE STE 340",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044647",
            "telephone_number": "818-500-8739",
            "fax_number": "818-500-0957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSICO",
        "first_name": "SARRAH JANE",
        "middle_name": "PEREZ",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-04",
        "last_updated": "2024-01-14",
        "certification_date": "2024-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95022073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.