Active NPI
Luxe Beauty and Wellness Boutique
- Family Nurse Practitioner
- Bellflower, CA
National Provider Identifier
1689327025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- LUXE BEAUTY AND WELLNESS BOUTIQUE
- Practice address
- 10242 Rosecrans Ave
Bellflower, CA 90706-2602 - Phone
- (562) 804-0000
- NPI assigned
- Jan 26, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kiiyonna Jones, FNP
- Title
- Nurse Practitioner
- Phone
- (310) 654-9047
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health & Wellness Coach | 171400000X | |||
| Clinical Medical Laboratory | 291U00000X | |||
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
10242 Rosecrans Ave
Bellflower, CA 90706-2602
Mailing address
10242 Rosecrans Ave
Bellflower, CA 90706-2602
Phone (562) 804-0000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220303001272 | CA | Part B Supplier - Mass Immunization (Roster Biller Only) | 1850785080 | Practice locations: Bellflower, CA |
National Provider Directory
National Provider DirectoryLocations
10242 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 804-0000
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Bellflower, CA
- NPI 1659029742
Health & Wellness Coach
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643155200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1646179200000",
"number": "1689327025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10242 ROSECRANS AVE",
"city": "BELLFLOWER",
"state": "CA",
"postal_code": "907062602",
"telephone_number": "562-804-0000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10242 ROSECRANS AVE",
"city": "BELLFLOWER",
"state": "CA",
"postal_code": "907062602",
"telephone_number": "562-804-0000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LUXE BEAUTY AND WELLNESS BOUTIQUE",
"organizational_subpart": "NO",
"enumeration_date": "2022-01-26",
"last_updated": "2022-03-02",
"certification_date": "2022-03-02",
"status": "A",
"authorized_official_last_name": "JONES",
"authorized_official_first_name": "KIIYONNA",
"authorized_official_title_or_position": "NURSE PRACTITIONER",
"authorized_official_telephone_number": "310-654-9047",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "FNP"
},
"taxonomies": [
{
"code": "171400000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Health & Wellness Coach",
"state": null,
"license": null,
"primary": false
},
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bellflower, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.