Individual provider Active NPI

Rebecca Wahinehookae, NP

  • Family Nurse Practitioner
  • Pomona, CA
National Provider Identifier
1518338169
Registry record updated Oct 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95003173 Issued in CA
Practice address
1177 N Park Ave
Pomona, CA 91768-3028
Phone
(909) 623-9900
NPI assigned
Oct 8, 2015
Last updated
Oct 8, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2015

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 95003173 CA Primary

Addresses

Primary practice location

1177 N Park Ave
Pomona, CA 91768-3028

Mailing address

1177 N Park Ave
Pomona, CA 91768-3028
Phone (909) 623-9900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160926002312 CA Order and Referring Only - Nurse Practitioner 7810284437

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95003173CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vijay C Katukota, a Medical Corporation PastSince Jul 1, 2004 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444262400000",
    "number": "1518338169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 N PARK AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917683028",
            "telephone_number": "909-623-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 N PARK AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917683028",
            "telephone_number": "909-623-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHINEHOOKAE",
        "first_name": "REBECCA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-08",
        "last_updated": "2015-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.