Individual provider Active NPI

Judie-Ann Dobalian, NP RNC

  • Women's Health Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1558768390
Registry record updated Feb 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
15380 Issued in CA
Practice address
6628 Cherry Ave
Long Beach, CA 90805-1715
Phone
(562) 531-3160
NPI assigned
Nov 21, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 15380 CA Primary

Addresses

Primary practice location

6628 Cherry Ave
Long Beach, CA 90805-1715

Mailing address

1037 Main St
Peekskill, NY 10566-2913
Phone (631) 866-2030

Other names 1

  • Judie-Ann Felix Former name

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
15380CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Karing Pediatrics Medical Group Past Accepting new patients

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": "1416528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486771200000",
    "number": "1558768390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 MAIN ST",
            "city": "PEEKSKILL",
            "state": "NY",
            "postal_code": "105662913",
            "telephone_number": "631-866-2030",
            "fax_number": "631-866-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6628 CHERRY AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908051715",
            "telephone_number": "562-531-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBALIAN",
        "first_name": "JUDIE-ANN",
        "name_prefix": "Ms.",
        "credential": "NP RNC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-21",
        "last_updated": "2017-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "15380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUDIE-ANN",
            "last_name": "FELIX",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2017; 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.