Active NPI
Mary N Kubota, ANP
- Primary Care Nurse Practitioner
- Temecula, CA
National Provider Identifier
1689840464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 11669
- Practice address
- 41238 Margarita Rd Ste 104
Temecula, CA 92591-5552 - Phone
- (951) 695-6787
- NPI assigned
- May 1, 2008
- 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 |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 11669 | CA | Primary |
Addresses
Primary practice location
41238 Margarita Rd Ste 104
Temecula, CA 92591-5552
Mailing address
PO Box 35380
Las Vegas, NV 89133-5380
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11669 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758758400000",
"number": "1689840464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 35380",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891335380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41238 MARGARITA RD STE 104",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925915552",
"telephone_number": "951-695-6787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUBOTA",
"first_name": "MARY",
"middle_name": "N",
"name_prefix": "Mrs.",
"credential": "ANP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-01",
"last_updated": "2025-09-25",
"certification_date": "2025-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "CA",
"license": "11669",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temecula, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.