Active NPI
April Lynette De la Cruz, P.A-C
- Physician Assistant
- Victorville, CA
National Provider Identifier
1629012422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA 17282
- Practice address
- 17259 Jasmine St
Ste B
Victorville, CA 92395-7787 - Phone
- (760) 951-7778
- Fax
- (760) 241-5950
- NPI assigned
- Jun 15, 2006
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 17282 | CA | Primary |
Addresses
Primary practice location
17259 Jasmine St
Ste B
Victorville, CA 92395-7787
Mailing address
17259 Jasmine St Ste B
Pob 1537
Victorville, CA 92395-7787
Phone (760) 951-7778
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0PA172820 | Medicaid | CA |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 17282 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317945600000",
"number": "1629012422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17259 JASMINE ST STE B",
"address_2": "POB 1537",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923957787",
"telephone_number": "760-951-7778",
"fax_number": "760-241-5950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17259 JASMINE ST",
"address_2": "STE B",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923957787",
"telephone_number": "760-951-7778",
"fax_number": "760-241-5950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LA CRUZ",
"first_name": "APRIL",
"middle_name": "LYNETTE",
"credential": "P.A-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-15",
"last_updated": "2011-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA 17282",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0PA172820",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.