Individual provider Active NPI

Sandra Yoshida-Perdomo, NURSE PRACTITIONER

  • Nurse Practitioner
  • Anaheim, CA
National Provider Identifier
1558675173
Registry record updated Dec 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
19927 Issued in CA
Practice address
1182 N Euclid St
Anaheim, CA 92801-1900
Phone
(714) 399-9222
NPI assigned
Aug 6, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 19927 CA Primary

Addresses

Primary practice location

1182 N Euclid St
Anaheim, CA 92801-1900

Mailing address

643 Silver Bridle Road
Walnut, CA 91789
Phone (626) 622-6869

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
I20240626003946 CA Practitioner - Nurse Practitioner 1557805983 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19927CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Albion Medical Partners of California West P C CurrentSince May 1, 2024 Accepting new patients

Locations

12900 Park Plaza Dr
Ste 700
Cerritos, CA 90703
Phone (562) 622-2800

12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800

Interoperability endpoints

  • Direct secure messaging: sandra.yoshidaperdomo.p1@direct.caremorewest.nextgenshare.com
  • Direct secure messaging: sandra.yoshida-perdomo.1@30710.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1281052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1558675173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "643 SILVER BRIDLE ROAD",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "91789",
            "telephone_number": "626-622-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1182 N EUCLID ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011900",
            "telephone_number": "714-399-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOSHIDA-PERDOMO",
        "first_name": "SANDRA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-06",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "19927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.