Active NPI
Maria Clennon, NP
- Family Nurse Practitioner
- Monrovia, CA
National Provider Identifier
1649692534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 22180
- Practice address
- 226 E Maple Ave
Monrovia, CA 91016-3549 - Phone
- (626) 930-1938
- NPI assigned
- Jan 10, 2014
- Last updated
- Jan 22, 2014
- 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 | 22180 | CA | Primary |
Addresses
Primary practice location
226 E Maple Ave
Monrovia, CA 91016-3549
Mailing address
226 E Maple Ave
Monrovia, CA 91016-3549
Phone (626) 930-1938
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22180 | Medicaid | CA |
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)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22180 | CA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City of Hope Medical Foundation | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Oncology Clinic/Center
- Duarte, CA
- NPI 1558823518
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390348800000",
"number": "1649692534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "226 E MAPLE AVE",
"city": "MONROVIA",
"state": "CA",
"postal_code": "910163549",
"telephone_number": "626-930-1938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "226 E MAPLE AVE",
"city": "MONROVIA",
"state": "CA",
"postal_code": "910163549",
"telephone_number": "626-930-1938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLENNON",
"first_name": "MARIA",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-10",
"last_updated": "2014-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "22180",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "22180",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monrovia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.