Individual provider Active NPI

Hazelle Lama Baylosis, NP

  • Gerontology Nurse Practitioner
  • National City, CA
National Provider Identifier
1720803463
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
95032369 Issued in CA
Practice address
1419 E 8TH St
National City, CA 91950-2602
Phone
(619) 718-1743
NPI assigned
Nov 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 95032369 CA Primary

Addresses

Primary practice location

1419 E 8TH St
National City, CA 91950-2602

Mailing address

1700 Oconnor Ave
Chula Vista, CA 91913-4324
Phone (619) 508-5834

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95032369CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Reliable Care Medical Group AMC PC CurrentSince Nov 24, 2024 Accepting new patients

Locations

1419 E 8th St
National City, CA 91950
Phone (619) 718-1743

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": "1731888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1720803463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 OCONNOR AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919134324",
            "telephone_number": "619-508-5834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 E 8TH ST",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502602",
            "telephone_number": "619-718-1743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYLOSIS",
        "first_name": "HAZELLE",
        "middle_name": "LAMA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95032369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.