Active NPI
Gracious K Basa, FNP
- Family Nurse Practitioner
- Murrieta, CA
National Provider Identifier
1649555939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 20961
- Practice address
- 41670 Ivy St Suite B
Murrieta, CA 92562-1707 - Phone
- (951) 600-7702
- Fax
- (951) 600-5987
- NPI assigned
- Oct 18, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 20961 | CA | Primary |
Addresses
Primary practice location
41670 Ivy St Suite B
Murrieta, CA 92562-1707
Mailing address
41670 Ivy St Suite B
Murrieta, CA 92562-1707
Phone (951) 600-7702
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)
- Enrolled
- Credentials
- Nurse Practitioner
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360281600000",
"number": "1649555939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41670 IVY ST SUITE B",
"city": "MURRIETA",
"state": "CA",
"postal_code": "925621707",
"telephone_number": "951-600-7702",
"fax_number": "951-600-5987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41670 IVY ST SUITE B",
"city": "MURRIETA",
"state": "CA",
"postal_code": "925621707",
"telephone_number": "951-600-7702",
"fax_number": "951-600-5987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASA",
"first_name": "GRACIOUS",
"middle_name": "K",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-18",
"last_updated": "2013-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "20961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Murrieta, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.