Individual provider Active NPI

Pratibha Sehgal, NP

  • Primary Care Nurse Practitioner
  • Palmdale, CA
National Provider Identifier
1700571114
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
95024383 Issued in CA
Practice address
1621 Angora Way
Palmdale, CA 93551-4374
Phone
(661) 406-4870
NPI assigned
Apr 11, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 98024383 CA
Gerontology Nurse Practitioner 363LG0600X 95024383 CA
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X 95024383 CA Primary

Addresses

Primary practice location

1621 Angora Way
Palmdale, CA 93551-4374

Mailing address

1621 Angora Way
Palmdale, CA 93551-4374
Phone (661) 406-4870

Other identifiers 1

IdentifierTypeStateIssuer
AG10220050OtherAANP CERTIFICATION NO

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
I20231005000766 CA Practitioner - Nurse Practitioner 5294180659 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
98024383CAMDAdult Health Nurse Practitioner
95024383CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Myndfull Care Management California PC Multi-Specialty CurrentSince Sep 1, 2023 Accepting new patients
Myndfull Care California PC Multi-Specialty CurrentSince Feb 14, 2024 Accepting new patients
California Care Wellness Medical Center Inc. Multi-Specialty CurrentSince Sep 1, 2023 Accepting new patients
Geri Connection Multi-Specialty CurrentSince Sep 1, 2023 Accepting new patients

Locations

15644 Pomerado Rd
Ste 202
Poway, CA 92064
Phone (619) 320-8090

8445 Camino Santa Fe
Ste 215
San Diego, CA 92121
Phone (619) 541-3246

6280 Jackson Dr
Ste 8
San Diego, CA 92119
Phone (619) 464-1607

9436 W Lake Mead Blvd
Ste 5
Las Vegas, NV 89134
Phone (760) 978-8596

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1700571114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 ANGORA WAY",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935514374",
            "telephone_number": "661-406-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 ANGORA WAY",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935514374",
            "telephone_number": "661-406-4870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEHGAL",
        "first_name": "PRATIBHA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-11",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "98024383",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95024383",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95024383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANP CERTIFICATION NO",
            "identifier": "AG10220050",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

Verify at the official NPI Registry.