Individual provider Active NPI

Tina Marie Altenau, RN, NP-BC

  • Adult Health Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1710142476
Registry record updated Sep 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
NP 18194 Issued in CA
Practice address
3525 Del Mar Heights Rd # 355
San Diego, CA 92130-2122
Phone
(619) 743-3315
NPI assigned
Jul 22, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NP 18194 CA Primary

Addresses

Primary practice location

3525 Del Mar Heights Rd # 355
San Diego, CA 92130-2122

Mailing address

3525 Del Mar Heights Rd # 355
San Diego, CA 92130-2122
Phone (619) 743-3315

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)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
NP 18194CAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Lance L. Altenau Past Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

Interoperability endpoints

  • Direct secure messaging: taltenau80394@scrippshlth.medalliesdirect.net

Organizations & group practices 2

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": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314921600000",
    "number": "1710142476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 DEL MAR HEIGHTS RD # 355",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302122",
            "telephone_number": "619-743-3315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 DEL MAR HEIGHTS RD # 355",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302122",
            "telephone_number": "619-743-3315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTENAU",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RN, NP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-22",
        "last_updated": "2011-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "NP 18194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.