Marylyn A. Hagerty, DNP FNP

Primary specialty

Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X

License

21337 Issued in CA

Practice address

12900 Park Plaza Dr Ste 150
Cerritos, CA 90703

Phone

(562) 229-4831

Fax

(949) 305-8520

NPI assigned

Jul 19, 2011

Last updated

Aug 4, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533340800000",
    "number": "1548558968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 CALLE MAYITA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926722306",
            "telephone_number": "949-933-2620",
            "fax_number": "949-361-5092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900 PARK PLAZA DR STE 150",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "90703",
            "telephone_number": "562-229-4831",
            "fax_number": "949-305-8520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGERTY",
        "first_name": "MARYLYN",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "DNP FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2018-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "CA",
            "license": "21337",
            "primary": true
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "CA",
            "license": "267941",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eddie Guzman, AUD
• Karla Guzman
• H Dermatology PC
• Ha Tran Tsai Dental Corporation
• Jiyoung Ha
• Leila Haidar
• Yelda Hakimi
• Hakimzadeh & Reyhani Dental Office of Cerritos. Inc. (Cerritos Dental Care)
• Charles Halbert
• Brent Alan Hale, L.C.S.W.

• Family Health Clinical Nurse Specialist in Cerritos, CA
• Providers in Cerritos, CA by specialty
• Family Health Clinical Nurse Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2018; 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.

Verify at the official NPI Registry.