Jean Nepomuceno Carlos, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

NP15130 Issued in CA

Practice address

415 Old Newport Blvd
Suite 200
Newport Beach, CA 92663-4248

Phone

(949) 548-9611

Fax

(949) 548-9958

NPI assigned

Apr 25, 2006

Last updated

Nov 2, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Jean Nepomuceno Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  NPD (past)

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288656000000",
    "number": "1740246982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 OLD NEWPORT BLVD",
            "address_2": "SUITE 200",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634248",
            "telephone_number": "949-548-9611",
            "fax_number": "949-548-9958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 OLD NEWPORT BLVD",
            "address_2": "SUITE 200",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634248",
            "telephone_number": "949-548-9611",
            "fax_number": "949-548-9958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLOS",
        "first_name": "JEAN",
        "middle_name": "NEPOMUCENO",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2010-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "NP15130",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "RN570100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEAN",
            "last_name": "NEPOMUCENO",
            "prefix": "MS.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Caring Companions at Home, Inc.
• Caring Hearts Play Therapy
• Leilani Jane Carinio, LMFT
• Carla Naragon, MFT
• Cameron M Carlen, M.D.
• Angela J Carlson, CPNP
• Gary Carlson, MD
• Lindsay Taylor Zotovich Carmack, PA-C
• Jessica Carmona
• Timothy Harry Carpenter, MD

• Acute Care Nurse Practitioner in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; 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.