Individual provider Active NPI

Marcia Dianne Kamman Varez, MSN, NNP, PNP

  • Critical Care Neonatal Nurse Practitioner
  • Tarzana, CA
National Provider Identifier
1629132642
Registry record updated Nov 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
562521 Issued in CA
Practice address
18321 Clark St
Tarzana, CA 91356-3501
Phone
(818) 708-5570
NPI assigned
Dec 21, 2006
Last updated
Nov 19, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X 562521 CA Primary

Addresses

Primary practice location

18321 Clark St
Tarzana, CA 91356-3501

Mailing address

12975 Agustin PL Apt 103
Playa Vista, CA 90094-2311
Phone (310) 745-1516

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
I20040227000630 CA Practitioner - Nurse Practitioner 3971499633 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
14668CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents CurrentSince Dec 1, 2015 Accepting new patients
UCLA Medical Group Past Accepting new patients

Locations

10833 Le Conte Ave
#12311
Los Angeles, CA 90095
Phone (310) 825-9124

200 UCLA Medical Plz
Ste 265
Los Angeles, CA 90095
Phone (310) 206-2429

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

757 Westwood Plz
Los Angeles, CA 90095
Phone (310) 267-9448

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

Interoperability endpoints

  • Direct secure messaging: mvarez53731@direct.uclahealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447891200000",
    "number": "1629132642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12975 AGUSTIN PL APT 103",
            "city": "PLAYA VISTA",
            "state": "CA",
            "postal_code": "900942311",
            "telephone_number": "310-745-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18321 CLARK ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563501",
            "telephone_number": "818-708-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAREZ",
        "first_name": "MARCIA",
        "middle_name": "DIANNE KAMMAN",
        "credential": "MSN, NNP, PNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2015-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "CA",
            "license": "562521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.