Fareeha Sipra, NURSE PRACTIONER

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

95013049 Issued in CA

Practice address

2029 Century Park E Ste 400
Los Angeles, CA 90067-2905

Phone

(559) 259-2478

NPI assigned

Oct 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1571961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1487297107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 M ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211805",
            "telephone_number": "559-600-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2029 CENTURY PARK E STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900672905",
            "telephone_number": "559-259-2478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Fresno County Jail",
            "address_2": "1225 M Street",
            "address_purpose": "LOCATION",
            "city": "fresno",
            "state": "CA",
            "postal_code": "93721",
            "country_code": "US",
            "telephone_number": "559-600-9360 x55960",
            "fax_number": "559-266-0100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1225 M St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937211805",
            "country_code": "US",
            "telephone_number": "559-600-9360 x55960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIPRA",
        "first_name": "FAREEHA",
        "credential": "NURSE PRACTIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-25",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95013049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95013049",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "wellpath",
            "affiliation": "N",
            "address_1": "1225 M St",
            "city": "Fresno",
            "state": "CA",
            "country_code": "US",
            "postal_code": "937211805",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "wellpath",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1225 M St",
            "city": "Fresno",
            "state": "CA",
            "country_code": "US",
            "postal_code": "937211805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Guillermo Siordia
• Siotame Lasitani, M.D., Inc.
• Matthew Siow, MD, MBA
• Quintin Edward Sipert Sr.
• Kelly Rae Siplinger, RN
• Bianca Alondra Sique
• Icinda J Siqueira-Darwin, PH.D.
• Steven Michael Siragusa, DO
• Sirak Darbinian a Professional Corporation
• Christine Nurien Siregar

• Gerontology Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, 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 May 31, 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.