Individual provider Active NPI

Reina D Moran, NP

  • Family Nurse Practitioner
  • Santa Ana, CA
National Provider Identifier
1518507698
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12262 Issued in CA
Practice address
1401 W 1St St Ste 101
Santa Ana, CA 92703-3757
Phone
(714) 542-9700
Fax
(714) 542-9708
NPI assigned
Jan 7, 2020
Last updated
Mar 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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 12262 CA Primary

Addresses

Primary practice location

1401 W 1St St Ste 101
Santa Ana, CA 92703-3757

Mailing address

14550 Haynes St
Van Nuys, CA 91411-1613
Phone (818) 650-6700

Other practice location 1

12100 Valley Blvd Ste 109A
El Monte, CA 91732-3161
Phone (626) 575-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prompt Laboratories Inc CurrentSince Aug 7, 2022 Accepting new patients
Southern California Medical Center, Inc. CurrentSince Feb 3, 2020 Accepting new patients
Southern California Medical Center, Inc. CurrentSince Feb 3, 2020 Accepting new patients
Advance Urgent Medical Group Inc CurrentSince Mar 3, 2024 Accepting new patients

Locations

1300 Valley Vista Dr
Ste 102
Diamond Bar, CA 91765
Phone (626) 389-7498

12100 Valley Blvd
Ste 109A
El Monte, CA 91732
Phone (626) 575-7500

1401 W 1st St
Ste 101
Santa Ana, CA 92703
Phone (714) 542-9700

Organizations & group practices 4

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": "1578355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1518507698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14550 HAYNES ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111613",
            "telephone_number": "818-650-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W 1ST ST STE 101",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927033757",
            "telephone_number": "714-542-9700",
            "fax_number": "714-542-9708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12100 Valley Blvd Ste 109A",
            "address_purpose": "LOCATION",
            "city": "El Monte",
            "state": "CA",
            "postal_code": "917323161",
            "country_code": "US",
            "telephone_number": "626-575-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORAN",
        "first_name": "REINA",
        "middle_name": "D",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-07",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "12262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.