Individual provider Active NPI

Sylvia Ingrid Vedder, N.P.

  • Acute Care Nurse Practitioner
  • Torrance, CA
National Provider Identifier
1497919542
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
429776 Issued in CA
Practice address
1000 W Carson St
Torrance, CA 90502-2004
Phone
(626) 969-9219
NPI assigned
Jul 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 429776 CA Primary

Addresses

Primary practice location

1000 W Carson St
Torrance, CA 90502-2004

Mailing address

114 N Barbara Ave
Azusa, CA 91702-4225
Phone (626) 969-9219

Other names 1

  • Sylvia Ingrid Mangowal Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120517000253 CA Practitioner - Nurse Practitioner 7719140375 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
429776CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Apr 14, 2012 Accepting new patients
County of Los Angeles CurrentSince Apr 14, 2012 Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

1000 W Carson St
Torrance, CA 90502
Phone (310) 222-3501

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": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216252800000",
    "number": "1497919542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 N BARBARA AVE",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917024225",
            "telephone_number": "626-969-9219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W CARSON ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022004",
            "telephone_number": "626-969-9219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEDDER",
        "first_name": "SYLVIA",
        "middle_name": "INGRID",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-17",
        "last_updated": "2008-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "429776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SYLVIA",
            "last_name": "MANGOWAL",
            "middle_name": "INGRID",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.