Individual provider Active NPI

Aziza Badaoui Najjar, PA

  • Physician Assistant
  • Chino Hills, CA
National Provider Identifier
1679208946
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61764 Issued in CA
Practice address
15855 Pomona Rincon Rd BLDG 4
Chino Hills, CA 91709-3162
Phone
(909) 264-8666
NPI assigned
Jul 20, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA61764 CA Primary

Addresses

Primary practice location

15855 Pomona Rincon Rd BLDG 4
Chino Hills, CA 91709-3162

Mailing address

15855 Pomona Rincon Rd BLDG 4
Chino Hills, CA 91709-3162
Phone (909) 264-8666

Other practice location 1

2251 N Harbor Blvd
Fullerton, CA 92835-2601
Phone (714) 449-6230

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
I20230123002656 CA Practitioner - Physician Assistant 6800267220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 546-3210

12550 Hesperia Rd
Suite 100
Victorville, CA 92395-5873
Phone (760) 241-6666

15855 Pomona Rincon Rd
BLDG 4
Chino Hills, CA 91709-3162
Phone (909) 929-2511

19333 Bear Valley Rd
Apple Valley, CA 92308-5149

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
61764CAMDClinical Social Worker
PA61764CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Dec 19, 2022 Accepting new patients
Providence Medical Foundation CurrentSince Dec 19, 2022 Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

19333 Bear Valley Rd
Ste 106
Apple Valley, CA 92308
Phone (760) 240-5505

15855 Pomona Rincon Rd
Bldg 4
Chino Hills, CA 91709
Phone (714) 626-8630

2251 N Harbor Blvd
Fullerton, CA 92835
Phone (714) 449-6230

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

Interoperability endpoints

  • Direct secure messaging: anajjar2029791@oc.providencedirect.org

Organizations & group practices 3

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": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1679208946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15855 POMONA RINCON RD BLDG 4",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917093162",
            "telephone_number": "909-264-8666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15855 POMONA RINCON RD BLDG 4",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917093162",
            "telephone_number": "909-264-8666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2251 N Harbor Blvd",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928352601",
            "country_code": "US",
            "telephone_number": "714-449-6230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAJJAR",
        "first_name": "AZIZA",
        "middle_name": "BADAOUI",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-20",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA61764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino Hills, CA

Sources for this page

Verify at the official NPI Registry.