Individual provider Active NPI

Jane Herico, N.P.

  • Nurse Practitioner
  • Riverside, CA
National Provider Identifier
1699191643
Registry record updated Mar 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
23150 Issued in CA
Practice address
9939 Magnolia Ave
Riverside, CA 92503-3528
Phone
(951) 687-8802
Fax
(951) 687-2250
NPI assigned
Mar 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 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 23150 CA Primary

Addresses

Primary practice location

9939 Magnolia Ave
Riverside, CA 92503-3528

Mailing address

9939 Magnolia Ave
Riverside, CA 92503-3528
Phone (951) 687-8802

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
I20150310000218 CA Practitioner - Nurse Practitioner 0345566378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Multi-Specialty Clinic CorpGroup PAC ID 6507295722, 2 clinicians

Practice addresses (Care Compare)

1557 E Amar Rd
Suite F
West Covina, CA 91792-1678
Phone (626) 839-9100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Multi-Specialty Clinic Corp CurrentSince Mar 11, 2020 Accepting new patients

Locations

1400 Circle City Dr
Corona, CA 92879
Phone (909) 735-0252

1557 E Amar Rd
Ste F
West Covina, CA 91792
Phone (626) 839-9100

Organizations & group practices 1

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": "1394755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394755200000",
    "number": "1699191643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9939 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033528",
            "telephone_number": "951-687-8802",
            "fax_number": "951-687-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9939 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033528",
            "telephone_number": "951-687-8802",
            "fax_number": "951-687-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERICO",
        "first_name": "JANE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-14",
        "last_updated": "2014-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "23150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.