Individual provider Active NPI

Jessica Latorre, PNP

  • Pediatric Nurse Practitioner
  • Orange, CA
National Provider Identifier
1528610375
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
95008908 Issued in CA
Practice address
431 S Batavia St Ste 203
Orange, CA 92868-3939
Phone
(949) 422-5344
NPI assigned
Jul 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 95008908 CA Primary

Addresses

Primary practice location

431 S Batavia St Ste 203
Orange, CA 92868-3939

Mailing address

1201 W la Veta Ave
Orange, CA 92868-4203
Phone (714) 639-0662

Other practice location 1

431 S Batavia St Ste 203
Orange, CA 92868-3939

Other practice location 2

431 S Batavia St
Orange, CA 92868-3936

Other practice location 3

431 S Batavia St Ste 203
Orange, CA 92868-3939

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

State licenses

LicenseStateTypeSpecialty
95008908CAMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1528610375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684203",
            "telephone_number": "714-639-0662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 S BATAVIA ST STE 203",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683939",
            "telephone_number": "949-422-5344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "431 S Batavia St Ste 203",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683939",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "431 S Batavia St",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683936",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "431 S Batavia St Ste 203",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683939",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATORRE",
        "first_name": "JESSICA",
        "credential": "PNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95008908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.