Individual provider Active NPI

Maritza Nogueda

  • Licensed Vocational Nurse
  • Santa Ana, CA
National Provider Identifier
1720620164
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
701785 Issued in CA
Practice address
2201 Kilson Dr
Santa Ana, CA 92707-2954
Phone
(714) 615-4238
NPI assigned
Oct 16, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 701785 CA Primary

Addresses

Primary practice location

2201 Kilson Dr
Santa Ana, CA 92707-2954

Mailing address

2205 Kilson Dr
Santa Ana, CA 92707-2952

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

State licenses

LicenseStateTypeSpecialty
701785CAMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Clean Path Recovery, LLC PastSince Oct 20, 2019 Accepting new patients

Organizations & group practices 1

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": "1571184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1720620164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 KILSON DR",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927072952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 KILSON DR",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927072954",
            "telephone_number": "714-615-4238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOGUEDA",
        "first_name": "MARITZA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-16",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "701785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.