Individual provider Active NPI

Walter Sosa Jr., NP

  • Family Nurse Practitioner
  • Loma Linda, CA
National Provider Identifier
1679019467
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95005669 Issued in CA
Practice address
11234 Anderson St
Loma Linda, CA 92354-2804
Phone
(909) 558-4000
NPI assigned
Jan 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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 95005669 CA Primary

Addresses

Primary practice location

11234 Anderson St
Loma Linda, CA 92354-2804

Mailing address

65 Country Club Dr
Calimesa, CA 92320-2013
Phone (909) 815-2215

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
I20190418002580 CA Practitioner - Nurse Practitioner 3476895566 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95005669CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jan 20, 2019 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Baromedical Physician Associates Medical Group CurrentSince Jun 23, 2020 Accepting new patients
California Wound Healing Medical Group Inc. CurrentSince May 5, 2025 Accepting new patients
Care360 Medical Group CurrentSince Jan 23, 2025 Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Loma Linda University Children'S Hospital Past Accepting new patients
New Hope Podiatry Group Inc. PastSince Dec 29, 2024 Accepting new patients

Locations

100 E Huntington Dr
Ste 209
Alhambra, CA 91801
Phone (323) 262-4146

5800 W Wilson St
Banning, CA 92220
Phone (323) 262-4146

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

222 N Pacific Coast Hwy
Ste 2175
El Segundo, CA 90245
Phone (877) 850-8762

23521 Paseo de Valencia
Ste 108
Laguna Hills, CA 92653
Phone (949) 396-1389

5750 Downey Ave
Ste 100
Lakewood, CA 90712
Phone (562) 630-3105

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11370 Anderson St
Ste 1800
Loma Linda, CA 92354
Phone (909) 558-2154

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

5430 Arlington Ave
Riverside, CA 92504
Phone (714) 458-4617

720 N Tustin Ave
Ste 100
Santa Ana, CA 92705
Phone (714) 973-8777

25044 Peachland Ave
Ste 110
Santa Clarita, CA 91321

25044 Peachland Ave
Ste 104
Santa Clarita, CA 91321
Phone (714) 458-4617

Interoperability endpoints

  • Direct secure messaging: wsosa55037@direct.llu.edu

Organizations & group practices 10

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": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1679019467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 COUNTRY CLUB DR",
            "city": "CALIMESA",
            "state": "CA",
            "postal_code": "923202013",
            "telephone_number": "909-815-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOSA",
        "first_name": "WALTER",
        "name_suffix": "Jr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-17",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.