Individual provider Active NPI

Alevtyna Izaak, REGISTERED NURSE BSN

  • Registered Nurse
  • Hermosa Beach, CA
National Provider Identifier
1497197834
Registry record updated Jul 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
841843 Issued in CA
Practice address
128 22ND St Apt 2a
Hermosa Beach, CA 90254-2511
Phone
(310) 970-2582
NPI assigned
Jul 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 841843 CA Primary

Addresses

Primary practice location

128 22ND St Apt 2a
Hermosa Beach, CA 90254-2511

Mailing address

128 22ND St Apt 2a
Hermosa Beach, CA 90254-2511
Phone (310) 970-2582

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
Credentials
Bachelor on Science - Nursing

State licenses

LicenseStateTypeSpecialty
841843CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1374796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374796800000",
    "number": "1497197834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 22ND ST APT 2A",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902542511",
            "telephone_number": "310-970-2582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 22ND ST APT 2A",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902542511",
            "telephone_number": "310-970-2582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZAAK",
        "first_name": "ALEVTYNA",
        "credential": "REGISTERED NURSE BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-26",
        "last_updated": "2013-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "841843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermosa Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2013; 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.