Organization Active NPI

Brightlane of California

  • Home Health Agency
  • Monrovia, CA
National Provider Identifier
1730792029
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
BRIGHTLANE OF CALIFORNIA
Practice address
503 1/2 S Myrtle Ave # 3
Monrovia, CA 91016-5101
Phone
(800) 780-2907
Fax
(323) 760-7224
NPI assigned
Aug 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Authorized official

Name
Marizol Cuevas
Title
President
Phone
(800) 780-2907

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

503 1/2 S Myrtle Ave # 3
Monrovia, CA 91016-5101

Mailing address

503 1/2 S Myrtle Ave Ste 3
Monrovia, CA 91016-5101
Phone (800) 780-2907

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Wellsky Health Information Exchange (HIE)

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2225458Brightlane of California503 1/2 S Myrtle Ave, Monrovia, CA 91016Certificate of waiverMay 19, 2027

National Provider Directory

National Provider Directory

Locations

503 S Myrtle Ave
#3
Monrovia, CA 91016
Phone (800) 780-2907

503 S Myrtle Ave
Ste 3
Monrovia, CA 91016

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613433600000",
    "number": "1730792029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 1/2 S MYRTLE AVE STE 3",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910165101",
            "telephone_number": "800-780-2907",
            "fax_number": "323-760-7224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 1/2 S MYRTLE AVE # 3",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910165101",
            "telephone_number": "800-780-2907",
            "fax_number": "323-760-7224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTLANE OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-26",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A",
        "authorized_official_last_name": "CUEVAS",
        "authorized_official_first_name": "MARIZOL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-780-2907"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Wellsky",
            "affiliation": "N",
            "endpointDescription": "Web base",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "503 1/2 S Myrtle Ave Ste 3",
            "city": "Monrovia",
            "state": "CA",
            "country_code": "US",
            "postal_code": "910165101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monrovia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.