Shayla Casanova, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95025590 Issued in CA

Practice address

425 Diamond Dr Ste 103
Lake Elsinore, CA 92530-4495

Phone

(951) 981-3122

NPI assigned

Jun 29, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Rancho Family Medical Group, Inc.

  dba Platinum Women's Health and Wellness

  • Family Medicine Physician
  • Temecula, CA
  • NPI 1598791600
  Medicare reassignment NPD
• Dr. Jimmy Phan Medical Corporation

  dba Lake ELsinore Pediatrics

  • Pediatrics Physician
  • Lake Elsinore, CA
  • NPI 1144989385
  NPD (past)
• UC San Diego Health - Rancho Family Medical Group

  • Multi-Specialty Clinic/Center
  • Temecula, CA
  • NPI 1003385071
  NPD (past)

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

{
    "created_epoch": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1710664990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30464 THICKET CT",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925633376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 DIAMOND DR STE 103",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304495",
            "telephone_number": "951-981-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASANOVA",
        "first_name": "SHAYLA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-29",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95025590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carla Patricia Campo, DDS
• Marisol Canett, LVN
• Alvin Lee Cabrera Cao
• Gloria Montes Cardona
• Marbella Adilene Carrillo
• Maria Castaneda-Alcaraz
• Shawn Rey Castellon, P.T.
• Misael Castillo
• Lourdes Castro
• Dulcinea R Catota, ASW

• Family Nurse Practitioner in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.