Individual provider Active NPI

Bianca Anne Porcuna Aguila, NP

  • Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1639754062
Registry record updated Oct 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
839425 Issued in NV
Practice address
1510 San Pablo St
Los Angeles, CA 90033-5320
Phone
(626) 457-6601
NPI assigned
Mar 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 839425 NV Primary

Addresses

Primary practice location

1510 San Pablo St
Los Angeles, CA 90033-5320

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (626) 457-6601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210806002751 NV Practitioner - Nurse Practitioner 8325442734 Reassigns benefits to 1 organization
I20230126003350 CA Practitioner - Nurse Practitioner 8325442734 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
839425NVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Jul 25, 2024 Accepting new patients
Absolute Primary Care Center Nurse Practitioner CurrentSince May 28, 2021 Accepting new patients
Emergency Physicians Associates Fremont PC CurrentSince Dec 19, 2022 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jul 25, 2024 Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

2000 Mowry Ave
Fremont, CA 94538
Phone (510) 793-6653

1812 Verdugo Blvd
Glendale, CA 91208
Phone (818) 246-8000

1510 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5910

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

3413 S Eastern Ave
Las Vegas, NV 89169
Phone (702) 796-1419

4218 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 425-5050

Interoperability endpoints

  • Direct secure messaging: bianca.aguila.1@25843.direct.athenahealth.com

Organizations & group practices 4

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": "1615939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729987200000",
    "number": "1639754062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "626-457-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 SAN PABLO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335320",
            "telephone_number": "626-457-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUILA",
        "first_name": "BIANCA",
        "middle_name": "ANNE PORCUNA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-17",
        "last_updated": "2024-10-27",
        "certification_date": "2024-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "839425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.