Individual provider Active NPI

Andrea Marie Yukio Herrera

  • Medical-Surgical Registered Nurse
  • Orange, CA
National Provider Identifier
1659118065
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
95349216 Issued in CA
Practice address
3063 W Chapman Ave Apt 4204
Orange, CA 92868-1754
Phone
(626) 267-4199
NPI assigned
Jul 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 95349216 CA Primary

Addresses

Primary practice location

3063 W Chapman Ave Apt 4204
Orange, CA 92868-1754

Mailing address

3063 W Chapman Ave Apt 4204
Orange, CA 92868-1754
Phone (626) 267-4199

Other identifiers 1

IdentifierTypeStateIssuer
95349216OtherCABOARD OF REGISTERED NURSING

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

State licenses

LicenseStateTypeSpecialty
95349216CAMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1720742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1659118065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3063 W CHAPMAN AVE APT 4204",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928681754",
            "telephone_number": "626-267-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3063 W CHAPMAN AVE APT 4204",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928681754",
            "telephone_number": "626-267-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "ANDREA MARIE",
        "middle_name": "YUKIO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-12",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "CA",
            "license": "95349216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF REGISTERED NURSING",
            "identifier": "95349216",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.