Individual provider Active NPI

Yohanna Ghebreyohannes

  • Family Nurse Practitioner
  • Cerritos, CA
National Provider Identifier
1730781071
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95015564 Issued in CA
Practice address
21750 Center Court Dr. S Suite 650
Cerritos, CA 90703
Phone
(323) 628-8671
Fax
(855) 883-6300
NPI assigned
Nov 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95015564 CA Primary

Addresses

Primary practice location

21750 Center Court Dr. S Suite 650
Cerritos, CA 90703

Mailing address

8491 Santa Monica Blvd
West Hollywood, CA 90069-4218
Phone (310) 360-7303

Other practice location 1

8491 Santa Monica Blvd
West Hollywood, CA 90069-4218
Phone (310) 360-7303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210514001620 CA Practitioner - Nurse Practitioner 5092124453 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95015564CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic Medical Group of California Inc Family CurrentSince Feb 2, 2021 Accepting new patients
Infusion4Health CurrentSince Jun 1, 2021 Accepting new patients

Locations

1401 S Baldwin Ave
Arcadia, CA 91007
Phone (626) 321-4210

2720 N Harbor Blvd
Ste 200
Fullerton, CA 92835
Phone (714) 449-6900

501 N Central Ave
Glendale, CA 91203
Phone (805) 505-7757

77 Rolling Oaks Dr
Ste 201
Thousand Oaks, CA 91361
Phone (805) 413-9099

8491 Santa Monica Blvd
West Hollywood, CA 90069
Phone (310) 360-7303

2791 Agoura Rd
Westlake Village, CA 91361
Phone 8054954938 ext. 8221

Interoperability endpoints

  • Direct secure messaging: yohanna.ghebreyohannes.p1@direct.ifh.nextgenshare.com
  • Direct secure messaging: yghebreyohannes@landmarkhealth-direct.org

Organizations & group practices 2

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": "1605052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1730781071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8491 SANTA MONICA BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900694218",
            "telephone_number": "310-360-7303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21750 CENTER COURT DR. S SUITE 650",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "90703",
            "telephone_number": "323-628-8671",
            "fax_number": "855-883-6300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8491 Santa Monica Blvd",
            "address_purpose": "LOCATION",
            "city": "West Hollywood",
            "state": "CA",
            "postal_code": "900694218",
            "country_code": "US",
            "telephone_number": "310-360-7303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHEBREYOHANNES",
        "first_name": "YOHANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-11",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95015564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

Verify at the official NPI Registry.