Active NPI
Loretta Leticia Contreras, PA-C
- Physician Assistant
- San Diego, CA
National Provider Identifier
1679096341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 54617
- Practice address
- 1501 Imperial Ave
San Diego, CA 92101-7638 - Phone
- (619) 645-6405
- NPI assigned
- Jul 24, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 54617 | CA | Primary |
Addresses
Primary practice location
1501 Imperial Ave
San Diego, CA 92101-7638
Mailing address
PO Box 86524
San Diego, CA 92138-6524
Phone (619) 977-9977
Other practice location 1
7801 Mission Center Ct Ste 250
San Diego, CA 92108-1314
Phone (619) 738-5566
Other practice location 2
1045 5th St
Los Banos, CA 93635
Phone (209) 827-4747
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54617 | CA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548201600000",
"number": "1679096341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 86524",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921386524",
"telephone_number": "619-977-9977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 IMPERIAL AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921017638",
"telephone_number": "619-645-6405"
}
],
"practiceLocations": [
{
"address_1": "7801 Mission Center Ct Ste 250",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921081314",
"country_code": "US",
"telephone_number": "619-738-5566",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1045 5th St",
"address_purpose": "LOCATION",
"city": "Los Banos",
"state": "CA",
"postal_code": "93635",
"country_code": "US",
"telephone_number": "209-827-4747",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CONTRERAS",
"first_name": "LORETTA",
"middle_name": "LETICIA",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-24",
"last_updated": "2019-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "54617",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.