Active NPI
Rita T Jefferson
- Community Health Worker
- Apple Valley, CA
National Provider Identifier
1508134693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 17800 US Highway 18
Apple Valley, CA 92307-1221 - Phone
- (760) 242-6336
- Fax
- (760) 946-0819
- NPI assigned
- Dec 5, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
17800 US Highway 18
Apple Valley, CA 92307-1221
Mailing address
17800 US Highway 18
Apple Valley, CA 92307-1221
Phone (760) 242-6336
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323043200000",
"number": "1508134693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17800 US HIGHWAY 18",
"city": "APPLE VALLEY",
"state": "CA",
"postal_code": "923071221",
"telephone_number": "760-242-6336",
"fax_number": "760-946-0819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17800 US HIGHWAY 18",
"city": "APPLE VALLEY",
"state": "CA",
"postal_code": "923071221",
"telephone_number": "760-242-6336",
"fax_number": "760-946-0819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEFFERSON",
"first_name": "RITA",
"middle_name": "T",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-05",
"last_updated": "2011-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Apple Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.