Individual provider Active NPI

Cerene Ciara George, FNP

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1609535558
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95019351 Issued in CA
Practice address
3030 Childrens Way
San Diego, CA 92123-4232
Phone
(858) 966-4003
NPI assigned
Dec 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95019351 CA Primary

Addresses

Primary practice location

3030 Childrens Way
San Diego, CA 92123-4232

Mailing address

3020 Childrens Way # Mc5003
San Diego, CA 92123-4223
Phone (858) 309-6300

Other practice location 1

2760 Fletcher Pkwy
El Cajon, CA 92020-2110
Phone (619) 461-4411

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
I20220311001243 CA Practitioner - Nurse Practitioner 8022403963 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95019351CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Marilyn Kaufhold, M.D., a Medical Corporation PastSince Apr 24, 2022 Accepting new patients

Organizations & group practices 2

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": "1638921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1609535558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5003",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-309-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 CHILDRENS WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234232",
            "telephone_number": "858-966-4003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2760 Fletcher Pkwy",
            "address_purpose": "LOCATION",
            "city": "El Cajon",
            "state": "CA",
            "postal_code": "920202110",
            "country_code": "US",
            "telephone_number": "619-461-4411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "CERENE",
        "middle_name": "CIARA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-08",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95019351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.