Individual provider Active NPI

Christina Ann Lagazo, NP

  • Nurse Practitioner
  • West Covina, CA
National Provider Identifier
1679056451
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95009779 Issued in CA
Practice address
1115 S Sunset Ave
West Covina, CA 91790-3940
Phone
(626) 814-2534
NPI assigned
Sep 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X NP95009779 CA
Nurse Practitioner 363L00000X 95009779 CA Primary

Addresses

Primary practice location

1115 S Sunset Ave
West Covina, CA 91790-3940

Mailing address

17049 E Francisquito Ave
West Covina, CA 91791-3828
Phone (808) 268-9054

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20181016001976 CA Practitioner - Nurse Practitioner 6002168226 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Valley Community Health Center, Inc.Group PAC ID 9234041765, shared by 4 NPIs, 50 clinicians

Practice addresses (Care Compare)

1555 S Garey Ave
Pomona, CA 91766-5222
Phone (626) 919-4333

420 S Glendora Ave
West Covina, CA 91790-3001
Phone 6269194333259

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95009779CAMDEmergency Medical Services (Emergency Medicine) Physician
95009779CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
May Medical Management Corporation CurrentSince May 29, 2021 Accepting new patients
Cep America-California CurrentSince Sep 1, 2018 Accepting new patients
Cep America - California Current Accepting new patients
Cep America - California CurrentSince Sep 1, 2018 Accepting new patients
Afshin Saadat MD Inc Current Accepting new patients
California Mobile Doctors Group Inc CurrentSince Sep 15, 2020 Accepting new patients

Locations

751 Medical Center Ct
#1182
Chula Vista, CA 91911

1234 Foothill Blvd
La Verne, CA 91750
Phone (909) 596-4879

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

8619 Reseda Blvd
Ste 201
Northridge, CA 91324
Phone (747) 217-8863

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

1317 W West Covina Pkwy
Ste B
West Covina, CA 91790
Phone (310) 733-8706

1115 S Sunset Ave
West Covina, CA 91790
Phone (626) 814-2434

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: christina.lagazo.p1@direct.evchc.nextgenshare.com

Organizations & group practices 6

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": "1536364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1679056451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17049 E FRANCISQUITO AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917913828",
            "telephone_number": "808-268-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S SUNSET AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903940",
            "telephone_number": "626-814-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGAZO",
        "first_name": "CHRISTINA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-08",
        "last_updated": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "CA",
            "license": "NP95009779",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95009779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1011 Baldwin Park Blvd",
            "city": "Baldwin Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917065806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.