Individual provider Active NPI

Cinaih Munguia, RN NP

  • Family Nurse Practitioner
  • Victorville, CA
National Provider Identifier
1710369046
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95001915 Issued in CA
Practice address
15403 Park Ave E
Victorville, CA 92392-2482
Phone
(714) 922-4100
NPI assigned
Jun 23, 2015
Last updated
Jan 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95001915 CA Primary

Addresses

Primary practice location

15403 Park Ave E
Victorville, CA 92392-2482

Mailing address

15403 Park Ave E
Victorville, CA 92392-2482
Phone (714) 922-4100

Other practice location 1

16519 Victor St
Ste. 307
Victorville, CA 92395-3965
Phone (760) 955-9555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151022002884 CA Order and Referring Only - Family PracticePractitioner - Family Practice 0547579005

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cal Choice Family Practice Inc Past Accepting new patients
Planned Parenthood/Orange and San Bernardino Counties, Inc. PastSince Jan 15, 2023 Accepting new patients

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, 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": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1710369046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15403 PARK AVE E",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922482",
            "telephone_number": "714-922-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15403 PARK AVE E",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922482",
            "telephone_number": "714-922-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16519 Victor St",
            "address_2": "STE. 307",
            "address_purpose": "LOCATION",
            "city": "Victorville",
            "state": "CA",
            "postal_code": "923953965",
            "country_code": "US",
            "telephone_number": "760-955-9555",
            "fax_number": "760-955-8558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNGUIA",
        "first_name": "CINAIH",
        "credential": "RN NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-23",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95001915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.