Individual provider Active NPI

Joan C Cedeno, NP-C

  • Family Nurse Practitioner
  • Carson, CA
National Provider Identifier
1518417484
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95004545 Issued in CA
Practice address
371 E 224TH St
Carson, CA 90745-3902
Phone
(310) 347-2452
NPI assigned
Oct 4, 2016
Last updated
Oct 4, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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 95004545 CA Primary

Addresses

Primary practice location

371 E 224TH St
Carson, CA 90745-3902

Mailing address

371 E 224TH St
Carson, CA 90745-3902
Phone (310) 347-2452

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
I20190620003380 CA Order and Referring Only - Nurse Practitioner 1850625021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95004545CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1518417484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 E 224TH ST",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907453902",
            "telephone_number": "310-347-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 E 224TH ST",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907453902",
            "telephone_number": "310-347-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEDENO",
        "first_name": "JOAN",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95004545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

Verify at the official NPI Registry.