Individual provider Active NPI

Adelita Tajolosa Cabagnot, NP

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1639250319
Registry record updated Oct 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
437493 Issued in CA
Practice address
10945 Le Conte Ave
Ste 2339
Los Angeles, CA 90095-3000
Phone
(310) 825-8253
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 437493 CA Primary

Addresses

Primary practice location

10945 Le Conte Ave
Ste 2339
Los Angeles, CA 90095-3000

Mailing address

10945 Le Conte Ave
Ste 2339
Los Angeles, CA 90095-3000
Phone (310) 825-8253

Other names 1

  • Adelita Fuentes Tajolosa Former name

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
I20060110001035 CA Practitioner - Nurse Practitioner 6002839545 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
437493CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California CurrentSince Jul 14, 2013 Accepting new patients
The Regents of the University of California CurrentSince Jul 14, 2013 Accepting new patients
UCLA Medical Group Past Accepting new patients
GN Medical Associates, Inc. Family PastSince Apr 1, 2007 Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

200 UCLA Medical Plz
Ste 365A
Los Angeles, CA 90095
Phone (310) 206-8272

File 55737
Los Angeles, CA 90074

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

Interoperability endpoints

  • Direct secure messaging: acabagnot108894@direct.uclahealth.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380844800000",
    "number": "1639250319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10945 LE CONTE AVE",
            "address_2": "STE 2339",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953000",
            "telephone_number": "310-825-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10945 LE CONTE AVE",
            "address_2": "STE 2339",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953000",
            "telephone_number": "310-825-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABAGNOT",
        "first_name": "ADELITA",
        "middle_name": "TAJOLOSA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2013-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "437493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADELITA",
            "last_name": "TAJOLOSA",
            "middle_name": "FUENTES",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.