Individual provider Active NPI

Jeffrey Idica

  • Naturopath
  • Palm Springs, CA
National Provider Identifier
1609329002
Registry record updated Oct 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
ND753 Issued in CA
Practice address
1775 E Palm Canyon Dr Ste 310
Palm Springs, CA 92264
Phone
(424) 335-9110
NPI assigned
Aug 2, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X ND753 CA Primary

Addresses

Primary practice location

1775 E Palm Canyon Dr Ste 310
Palm Springs, CA 92264

Mailing address

1775 E Palm Canyon Dr Ste 310
Palm Springs, CA 92264-1646
Phone (424) 335-9110

Other practice location 1

36101 Bob Hope Dr Ste B2
Rancho Mirage, CA 92270-2003
Phone (760) 321-1315

Other practice location 2

1775 E Palm Canyon Dr Ste 310
Palm Springs, CA 92264
Phone (424) 335-9110

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
ND753CAMDNaturopath

NPI Registry JSON

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1609329002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 E PALM CANYON DR STE 310",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922641646",
            "telephone_number": "424-335-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 E PALM CANYON DR STE 310",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "92264",
            "telephone_number": "424-335-9110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36101 Bob Hope Dr Ste B2",
            "address_purpose": "LOCATION",
            "city": "Rancho Mirage",
            "state": "CA",
            "postal_code": "922702003",
            "country_code": "US",
            "telephone_number": "760-321-1315",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1775 E Palm Canyon Dr Ste 310",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "92264",
            "country_code": "US",
            "telephone_number": "424-335-9110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IDICA",
        "first_name": "JEFFREY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-02",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "CA",
            "license": "ND753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; 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.