Iliana Beatrix Hendrix, CST

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

Practice address

22726 Madrid Dr
Lake Forest, CA 92630-4625

Phone

(949) 434-9044

NPI assigned

Dec 24, 2020

Last updated

Jun 10, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Iliana Beatriz Ortiz-Menjivar Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1608768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1629665518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22726 MADRID DR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926304625",
            "telephone_number": "949-434-9044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22726 MADRID DR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926304625",
            "telephone_number": "949-434-9044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRIX",
        "first_name": "ILIANA",
        "middle_name": "BEATRIX",
        "credential": "CST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-24",
        "last_updated": "2021-06-10",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "EHR",
            "affiliation": "N",
            "endpointDescription": "Electronic communication",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct message",
            "address_1": "22726 Madrid Dr",
            "city": "Lake Forest",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926304625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ILIANA",
            "last_name": "ORTIZ-MENJIVAR",
            "middle_name": "BEATRIZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Surgical Technologist in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Surgical Technologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.