Individual provider Active NPI

Dena Arellano, NP

  • Nurse Practitioner
  • Loma Linda, CA
National Provider Identifier
1689936692
Registry record updated Oct 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
394588 Issued in CA
Practice address
11234 Anderson St
Loma Linda, CA 92354-2804
Phone
(909) 558-8514
Fax
(909) 558-7873
NPI assigned
Jun 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 394588 CA Primary

Addresses

Primary practice location

11234 Anderson St
Loma Linda, CA 92354-2804

Mailing address

11234 Anderson St
Loma Linda, CA 92354-2804
Phone (909) 558-8514

Other identifiers 1

IdentifierTypeStateIssuer
18649OtherCARN LICENSE NUMBER 394588

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
I20160324000485 CA Practitioner - Nurse Practitioner 8729385455 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
394588CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Nephrology CurrentSince Feb 8, 2016 Accepting new patients
Diagnostic Imaging Services Past Accepting new patients
Eisenhower Medical Center Past Accepting new patients

Locations

1180 N Indian Canyon Dr
Ste W303
Palm Springs, CA 92262
Phone (760) 416-4819

69730 Highway 111
Ste 107
Rancho Mirage, CA 92270
Phone (760) 328-6575

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dena.arellano@direct.davitaphysiciansolutions.com

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": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414713600000",
    "number": "1689936692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-8514",
            "fax_number": "909-558-7873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-8514",
            "fax_number": "909-558-7873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARELLANO",
        "first_name": "DENA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-14",
        "last_updated": "2014-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "394588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE NUMBER 394588",
            "identifier": "18649",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.