Individual provider Active NPI

Angelica Joy Samich, FNP

  • Family Nurse Practitioner
  • Newport Beach, CA
National Provider Identifier
1487241220
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95013506 Issued in CA
Practice address
1 Hoag Dr
Newport Beach, CA 92663-4162
Phone
(949) 764-4624
NPI assigned
Dec 28, 2020
Last updated
Dec 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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 95013506 CA Primary

Addresses

Primary practice location

1 Hoag Dr
Newport Beach, CA 92663-4162

Mailing address

1 Hoag Dr
Newport Beach, CA 92663-4162
Phone (949) 764-8296

Other practice location 1

287 16th Pl Apt 8
Costa Mesa, CA 92627-3877
Phone (218) 393-8896

Other practice location 2

3828 Delmas Terrace
Culver City, CA 90232-9023
Phone (310) 202-4711

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
95013506CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1609113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1487241220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOAG DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634162",
            "telephone_number": "949-764-8296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOAG DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634162",
            "telephone_number": "949-764-4624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "287 16th Pl Apt 8",
            "address_purpose": "LOCATION",
            "city": "Costa Mesa",
            "state": "CA",
            "postal_code": "926273877",
            "country_code": "US",
            "telephone_number": "218-393-8896",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3828 Delmas Terrace",
            "address_purpose": "LOCATION",
            "city": "Culver City",
            "state": "CA",
            "postal_code": "902329023",
            "country_code": "US",
            "telephone_number": "310-202-4711",
            "fax_number": "310-202-4107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMICH",
        "first_name": "ANGELICA",
        "middle_name": "JOY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-28",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95013506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; 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.