Active NPI
Barbara Nicolulis
- Community Health Worker
- Canoga Park, CA
National Provider Identifier
1619008760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 6800 Owensmouth Ave
Canoga Park, CA 91303-3159 - Phone
- (818) 610-6764
- NPI assigned
- Mar 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
6800 Owensmouth Ave
Canoga Park, CA 91303-3159
Mailing address
44903 17TH St W
Lancaster, CA 93534-2009
Phone (661) 942-4993
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522195200000",
"number": "1619008760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44903 17TH ST W",
"city": "LANCASTER",
"state": "CA",
"postal_code": "935342009",
"telephone_number": "661-942-4993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6800 OWENSMOUTH AVE",
"city": "CANOGA PARK",
"state": "CA",
"postal_code": "913033159",
"telephone_number": "818-610-6764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICOLULIS",
"first_name": "BARBARA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-08",
"last_updated": "2018-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canoga Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.