Individual provider Active NPI

Cristina Hamdja, FNP-C

  • Family Nurse Practitioner
  • Anaheim, CA
National Provider Identifier
1669991014
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95007418 Issued in CA
Practice address
801 N Harbor Blvd
Anaheim, CA 92805-1810
Phone
(714) 774-7500
NPI assigned
Sep 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95007418 CA Primary

Addresses

Primary practice location

801 N Harbor Blvd
Anaheim, CA 92805-1810

Mailing address

411 Goetz PL
Placentia, CA 92870-6319
Phone (714) 944-1889

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20191212000837 CA Practitioner - Nurse Practitioner 9032542683 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95022650CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Medical Clinic, Inc CurrentSince Aug 21, 2019 Accepting new patients

Locations

801 N Harbor Blvd
Anaheim, CA 92805
Phone (714) 337-4640

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1669991014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 GOETZ PL",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928706319",
            "telephone_number": "714-944-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N HARBOR BLVD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928051810",
            "telephone_number": "714-774-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMDJA",
        "first_name": "CRISTINA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-18",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95007418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.