Individual provider Active NPI

Charienez Santos Cruz, FNP-BC

  • Family Nurse Practitioner
  • Gardena, CA
National Provider Identifier
1457052631
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95021842 Issued in CA
Practice address
1145 W Redondo Beach Blvd
Gardena, CA 90247-3511
Phone
(310) 532-4200
NPI assigned
Mar 14, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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 95021842 CA Primary

Addresses

Primary practice location

1145 W Redondo Beach Blvd
Gardena, CA 90247-3511

Mailing address

11645 209TH St Apt 7
Lakewood, CA 90715-1379
Phone (562) 881-9324

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
I20230803003571 CA Practitioner - Nurse Practitioner 8224499405 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

2195 Sepulveda Blvd
Torrance, CA 90501-4616
Phone (424) 337-1600

2613 Pacific Coast Hwy
Torrance, CA 90505-7037
Phone (424) 625-0220

26777 Agoura Rd
Suite B4
Calabasas, CA 91302-2967
Phone (818) 880-2225

3932 Long Beach Blvd
Suite a
Long Beach, CA 90807-2615
Phone (562) 855-2800

395 Silver Spur Rd
Rolling Hills Estates, CA 90274-3569
Phone (424) 323-3500

5101 Lakewood Blvd
Lakewood, CA 90712-2413
Phone (562) 800-3883

8135 N Painter Ave
Suite 104
Whittier, CA 90602-3164
Phone (562) 758-2345

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95021842CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Redondo Emergency Physicians, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Exer Medical Corporation CurrentSince Dec 1, 2023 Accepting new patients

Locations

26777 Agoura Rd
Calabasas, CA 91302
Phone (818) 880-2225

26777 Agoura Rd
Ste 4
Calabasas, CA 91302
Phone (818) 880-2225

235 E 17th St
Costa Mesa, CA 92627
Phone (949) 688-2010

2381 Rosecrans Ave
Ste 115
El Segundo, CA 90245
Phone (213) 335-7355

1145 W Redondo Beach Blvd
Gardena, CA 90247
Phone (310) 532-4200

7000 Boulder Ave
Ste 103
Highland, CA 92346
Phone (515) 441-6271

25548 The Old Rd
Ste U1
Stevenson Ranch, CA 91381
Phone (661) 556-9020

701 N Wendy Dr
Thousand Oaks, CA 91320
Phone (805) 375-4400

23341 Mulholland Dr
Woodland Hills, CA 91364
Phone (818) 637-0048

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": "1678752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1457052631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11645 209TH ST APT 7",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907151379",
            "telephone_number": "562-881-9324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 W REDONDO BEACH BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473511",
            "telephone_number": "310-532-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "CHARIENEZ",
        "middle_name": "SANTOS",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95021842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.