Conchita Esther Portilla, NURSE PRACTITIONER P

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

402401 Issued in CA

Practice address

400 N Pepper Ave
Pediatrics Administration
Colton, CA 92324-1819

Phone

(909) 498-6277

Fax

(909) 580-3235

NPI assigned

Apr 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Conchita Esther Leon Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419206400000",
    "number": "1649232075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N. PEPPER AVE.",
            "address_2": "PEDIATRICS ADMINISTRATION",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241819",
            "telephone_number": "909-498-6277",
            "fax_number": "909-580-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "address_2": "PEDIATRICS ADMINISTRATION",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241819",
            "telephone_number": "909-498-6277",
            "fax_number": "909-580-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTILLA",
        "first_name": "CONCHITA",
        "middle_name": "ESTHER",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2014-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "402401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONCHITA",
            "last_name": "LEON",
            "middle_name": "ESTHER",
            "credential": "NURSE PRACTITIONER P",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Joaquin Ponce-Paiz
• Lia Pop, PHARM.D.
• Nehemiah Villarias Porsona, R.D.
• Chris E Porter, O.T.
• Carolynn M Porterfield
• Stephanie Leticia Portillo
• Hannah Maria Pou
• Jacqueline Powell
• Angeli Joy Balagtas Poyaoan
• Richard Lewis Preci, D.O

• Pediatric Nurse Practitioner in Colton, CA
• Providers in Colton, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; 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.