Individual provider Active NPI

Derrick Wing Ning NG, RN

  • Psychiatric/Mental Health Registered Nurse
  • Los Angeles, CA
National Provider Identifier
1730332719
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
658357 Issued in CA
Practice address
450 Bauchet St
Los Angeles, CA 90012-2907
Phone
(213) 893-5392
NPI assigned
Nov 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95016233 CA
Psychiatric/Mental Health Registered Nurse 163WP0808X 658357 CA Primary

Addresses

Primary practice location

450 Bauchet St
Los Angeles, CA 90012-2907

Mailing address

3652 Primavera Ave
Los Angeles, CA 90065-3312
Phone (323) 229-5993

Other practice location 1

560 S St Louis St
Los Angeles, CA 90033-4320
Phone (213) 480-1557

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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

150 E Olive Ave
Suite 203
Burbank, CA 91502-1849

3652 Primavera Ave
Los Angeles, CA 90065-3312

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
658357CAMDPsychiatric/Mental Health Registered Nurse
95016233CAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1730332719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3652 PRIMAVERA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900653312",
            "telephone_number": "323-229-5993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BAUCHET ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900122907",
            "telephone_number": "213-893-5392"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "560 S St Louis St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900334320",
            "country_code": "US",
            "telephone_number": "213-480-1557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NG",
        "first_name": "DERRICK",
        "middle_name": "WING NING",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-04",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95016233",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "658357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.