Crpa LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CRPA LLC

Practice address

525 S Central Ave
Glendale, CA 91204-2006

Phone

(818) 240-1610

Fax

(818) 845-1169

NPI assigned

Oct 11, 2022

Last updated

Oct 11, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Caroline Tapang Ditullio

Title

Co-Manager

Phone

(626) 523-8956

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1665446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665446400000",
    "number": "1669197620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4016 GRAND AVE STE A-1056",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917105491",
            "telephone_number": "626-523-8956",
            "fax_number": "626-657-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 S CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042006",
            "telephone_number": "818-240-1610",
            "fax_number": "818-845-1169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-11",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A",
        "authorized_official_last_name": "DITULLIO",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_middle_name": "TAPANG",
        "authorized_official_title_or_position": "CO-MANAGER",
        "authorized_official_telephone_number": "626-523-8956"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT06190F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; 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.