Active NPI
Carrie Alicia Valencia, FNP
- Family Nurse Practitioner
- Los Angeles, CA
National Provider Identifier
1548016827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95029837
- Practice address
- 2707 S Central Ave
Los Angeles, CA 90011-5527 - Phone
- (323) 234-5000
- Fax
- (323) 231-3985
- NPI assigned
- Apr 26, 2024
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95029837 | CA | Primary |
Addresses
Primary practice location
2707 S Central Ave
Los Angeles, CA 90011-5527
Mailing address
13902 Fiji Way Apt 120
Marina del Rey, CA 90292-6922
Phone (956) 535-0200
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240716000347 | CA | Order and Referring Only - Nurse Practitioner | 1557806411 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95029837 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714089600000",
"number": "1548016827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13902 FIJI WAY APT 120",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902926922",
"telephone_number": "956-535-0200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2707 S CENTRAL AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900115527",
"telephone_number": "323-234-5000",
"fax_number": "323-231-3985"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALENCIA",
"first_name": "CARRIE",
"middle_name": "ALICIA",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-26",
"last_updated": "2024-04-26",
"certification_date": "2024-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95029837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.