Individual provider Active NPI

Valerie Agustin

  • Registered Nurse
  • San Diego, CA
National Provider Identifier
1740650803
Registry record updated Oct 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
800964 Issued in CA
Practice address
1443 Nashville St
San Diego, CA 92110-3713
Phone
(619) 276-8400
NPI assigned
Oct 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 800964 CA Primary

Addresses

Primary practice location

1443 Nashville St
San Diego, CA 92110-3713

Mailing address

7020 Gunzan St
San Diego, CA 92139-2112
Phone (619) 632-0015

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

State licenses

LicenseStateTypeSpecialty
800964CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Valerie Agustin Registered Nurse Past Accepting new patients

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": "1443657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443657600000",
    "number": "1740650803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7020 GUNZAN ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921392112",
            "telephone_number": "619-632-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1443 NASHVILLE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103713",
            "telephone_number": "619-276-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUSTIN",
        "first_name": "VALERIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-01",
        "last_updated": "2015-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "800964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; 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.