Nicole Hanley, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95016719 Issued in CA

Practice address

29798 Haun Rd Ste 207
Sun City, CA 92586-6542

Phone

(951) 679-9700

NPI assigned

Feb 19, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Center for New Directions, Inc.

  • Mental Health Counselor
  • Laguna Hills, CA
  • NPI 1578121190

  CA

  Medicare reassignment NPD
• Elite Medical Group PC

  • Multi-Specialty Clinic/Center
  • Corona, CA
  • NPI 1083233902
  NPD (past)
• Stephen M Pumphrey Licensed Clinical Social Workers Inc

  • Clinical Social Worker
  • Laguna Hills, CA
  • NPI 1386862969
  NPD (past)
• Vadim Gurvits

  • Occupational Medicine Clinic/Center
  • Sun City, CA
  • NPI 1437233905
  NPD (past)

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

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1659964765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8912 CONWAY DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925032171",
            "telephone_number": "951-367-8703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29798 HAUN RD STE 207",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925866542",
            "telephone_number": "951-679-9700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2083 Compton Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "CA",
            "postal_code": "928813416",
            "country_code": "US",
            "telephone_number": "951-268-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANLEY",
        "first_name": "NICOLE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-19",
        "last_updated": "2021-02-19",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95016719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick D. Gonzales, M.D.
• Marlyn Gonzalez
• Guiding Behavior Outcomes LLC
• Amy Guilbault, DPT
• H. Pourshirazi DMD, Inc
• Sandy Hanna, OD
• Todd Christopher Hanna, M.D.
• Guadalupe Haro Trujillo
• Donna Hastert, P.A.-C
• Thavisab Noy Hatlavongsa, D.D.S.

• All providers in Sun City, CA
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.