Priscilla Stephanie Inda, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

54404 Issued in CA

Practice address

429 Broadway
Chula Vista, CA 91910-4320

Phone

(619) 434-0204

Fax

(619) 337-0191

NPI assigned

May 1, 2017

Last updated

Sep 16, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Priscilla Stephanie La Berge-Inda Former name

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

Specialty

Physician Assistant

Education

Stanford University School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hassan Kafri MD IncGroup PAC ID 7618023805, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: priscilla.labergeinda@575.securemail.prognocis.com

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.

• Hassan Kafri MD, Inc.

  • Interventional Cardiology Physician
  • La Mesa, CA
  • NPI 1760626477
  Medicare reassignment Care Compare group
• Centro de Salud de la Comunidad de San Ysidro, Inc.

  dba San Ysidro Health Precision Park

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1124782685
  Medicare reassignment
• Centro de Salud de la Comunidad de San Ysidro Inc

  dba San Ysidro Health Senior Dental Center

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1457033813
  NPD
• Centro de Salud de la Comunidad de San Ysidro, Inc.

  dba San Diego PACE Chula Vista

  • PACE Provider Organization
  • Chula Vista, CA
  • NPI 1376195040
  NPD

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1679008379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 BROADWAY",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104320",
            "telephone_number": "619-434-0204",
            "fax_number": "619-337-0191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 BROADWAY",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104320",
            "telephone_number": "619-434-0204",
            "fax_number": "619-337-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INDA",
        "first_name": "PRISCILLA",
        "middle_name": "STEPHANIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-01",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "54404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PRISCILLA",
            "last_name": "LA BERGE-INDA",
            "middle_name": "STEPHANIE",
            "prefix": "MRS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jillian Imilkowski, DACM, LAC., LMT
• Imr Americas
• In-Motion PT Inc
• Inadvance Medicine Associates West, P. C. (Passport Health)
• Frances Noemy Inda
• Ricardo A Indacochea, MD
• Carmelina Infantino
• Infertility Obstetrics & Gynecology Medical Group of Chula Vista
• Emily Parani Ingco
• Alexis Taylor Ingrassia, AMFT

• Physician Assistant in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.