Individual provider Active NPI

Prudence Lu, NP

  • Adult Health Nurse Practitioner
  • Arcadia, CA
National Provider Identifier
1720416704
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
23696 Issued in CA
Practice address
620 Beverly Dr
Arcadia, CA 91006
Phone
(626) 538-7583
NPI assigned
Oct 29, 2013
Last updated
Feb 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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 23696 CA Primary

Addresses

Primary practice location

620 Beverly Dr
Arcadia, CA 91006

Mailing address

1553 W 37TH St
Los Angeles, CA 90018-4522
Phone (626) 538-7583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1720416704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1553 W 37TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900184522",
            "telephone_number": "626-538-7583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 BEVERLY DR",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "91006",
            "telephone_number": "626-538-7583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LU",
        "first_name": "PRUDENCE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-29",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "23696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

Verify at the official NPI Registry.