Active NPI
Angelina Abbaszade, FNP
- Licensed Practical Nurse
- Lake Forest, CA
National Provider Identifier
1619709649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 95026262
- Practice address
- 23672 Birtcher Dr Ste a
Lake Forest, CA 92630-1711 - Phone
- (949) 770-7301
- NPI assigned
- Aug 19, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 95026262 | CA | Primary |
Addresses
Primary practice location
23672 Birtcher Dr Ste a
Lake Forest, CA 92630-1711
Mailing address
308 S Vista del Canon
Anaheim, CA 92807-3836
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260112003365 | CA | Order and Referring Only - Family Practice | 2860978509 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95026262 | CA | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724025600000",
"number": "1619709649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 S VISTA DEL CANON",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928073836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23672 BIRTCHER DR STE A",
"city": "LAKE FOREST",
"state": "CA",
"postal_code": "926301711",
"telephone_number": "949-770-7301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABBASZADE",
"first_name": "ANGELINA",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-19",
"last_updated": "2024-08-19",
"certification_date": "2024-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "CA",
"license": "95026262",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Forest, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.