Individual provider Active NPI

Alba Nidia Casco, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Chula Vista, CA
National Provider Identifier
1689066490
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95001957 Issued in CA
Practice address
251 Landis Ave
Chula Vista, CA 91910-2628
Phone
(619) 515-2500
NPI assigned
Mar 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 95001957 CA
Family Nurse Practitioner 363LF0000X 95001957 CA Primary

Addresses

Primary practice location

251 Landis Ave
Chula Vista, CA 91910-2628

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 515-2300

Other identifiers 1

IdentifierTypeStateIssuer
95001957OtherCAMEDICAL LIC

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
I20220318000304 CA Practitioner - Nurse Practitioner 3870988413 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95001957CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
La Maestra Family Clinic, Inc. CurrentSince Nov 10, 2021 Accepting new patients
Family Health Centers of San Diego Inc Current Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Oct 28, 2024 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Oct 28, 2024 Accepting new patients
La Maestra Family Clinic, Inc. CurrentSince Nov 10, 2021 Accepting new patients
La Maestra Family Clinic, Inc. Current Accepting new patients

Locations

251 Landis Ave
Chula Vista, CA 91910
Phone (619) 515-2500

165 S 1st St
El Cajon, CA 92019
Phone (619) 312-0347

217 Highland Ave
National City, CA 91950
Phone (619) 280-4213

4060 Fairmount Ave
San Diego, CA 92105
Phone (619) 255-9155

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 7

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": "1425340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1689066490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-515-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 LANDIS AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102628",
            "telephone_number": "619-515-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASCO",
        "first_name": "ALBA",
        "middle_name": "NIDIA",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-03",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "95001957",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95001957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LIC",
            "identifier": "95001957",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.