Individual provider Active NPI

Ivy Allen

  • Attendant Care Provider
  • Moreno Valley, CA
National Provider Identifier
1629650163
Registry record updated Apr 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Attendant Care ProviderTaxonomy code 3747A0650X
Practice address
26460 Mapleridge Way
Moreno Valley, CA 92555-2205
Phone
(951) 363-8099
NPI assigned
Apr 24, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Attendant Care Provider 3747A0650X Primary

Addresses

Primary practice location

26460 Mapleridge Way
Moreno Valley, CA 92555-2205

Mailing address

26460 Mapleridge Way
Moreno Valley, CA 92555-2205
Phone (951) 363-8099

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": "1619222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619222400000",
    "number": "1629650163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26460 MAPLERIDGE WAY",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925552205",
            "telephone_number": "951-363-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26460 MAPLERIDGE WAY",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925552205",
            "telephone_number": "951-363-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "IVY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-24",
        "last_updated": "2021-04-24",
        "certification_date": "2021-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.