Individual provider Active NPI

Sandra G Ulloa, RN

  • Case Management Registered Nurse
  • Los Angeles, CA
National Provider Identifier
1720121353
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
License
678160 Issued in CA
Practice address
5425 Pomona Blvd
Los Angeles, CA 90022-1716
Phone
(323) 728-0411
NPI assigned
Feb 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X 678160 CA Primary

Addresses

Primary practice location

5425 Pomona Blvd
Los Angeles, CA 90022-1716

Mailing address

4727 Dozier Ave
Los Angeles, CA 90022-1320
Phone (323) 262-1122

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
678160CAMDCase Management Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720121353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4727 DOZIER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221320",
            "telephone_number": "323-262-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 POMONA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221716",
            "telephone_number": "323-728-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLOA",
        "first_name": "SANDRA",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "CA",
            "license": "678160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.