Individual provider Active NPI

Carol Hungha Fok, RNP

  • General Practice Registered Nurse
  • Westlake Village, CA
National Provider Identifier
1477685055
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
NP15672 Issued in CA
Practice address
30818 Overfall Dr
Westlake Village, CA 91362-4116
Phone
(818) 719-2793
NPI assigned
Mar 10, 2007
Last updated
Dec 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X NP15672 CA
General Practice Registered Nurse 163WG0000X NP15672 CA Primary

Addresses

Primary practice location

30818 Overfall Dr
Westlake Village, CA 91362-4116

Mailing address

5601 De Soto Ave
Woodland Hills, CA 91367-6701
Phone (818) 719-2793

Other identifiers 1

IdentifierTypeStateIssuer
NP15672OtherCALICENSE NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20080215000302 CA Practitioner - Nurse Practitioner 2961585856 Reassigns benefits to 1 organization
Practice locations: Westlake Village, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP15672CAMDGeneral Practice Registered Nurse
15672CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Sep 10, 2018 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 10, 2018 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

Organizations & group practices 3

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": "1173484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1477685055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 DE SOTO AVE",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913676701",
            "telephone_number": "818-719-2793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30818 OVERFALL DR",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913624116",
            "telephone_number": "818-719-2793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOK",
        "first_name": "CAROL",
        "middle_name": "HUNGHA",
        "name_prefix": "Ms.",
        "credential": "RNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-10",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "CA",
            "license": "NP15672",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "NP15672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "NP15672",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5601 De Soto Ave",
            "city": "Woodland Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913676701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Westlake Village, CA

Sources for this page

Verify at the official NPI Registry.