Individual provider Active NPI

Lisa Tonelli Laguna, NP

  • Family Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1750928388
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95013683 Issued in CA
Practice address
500 W Willow St Ste 101
Long Beach, CA 90806-2831
Phone
(562) 427-1700
NPI assigned
Dec 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 491651 CA
Family Nurse Practitioner 363LF0000X 95013683 CA Primary

Addresses

Primary practice location

500 W Willow St Ste 101
Long Beach, CA 90806-2831

Mailing address

2005 Ernest Ave
Redondo Beach, CA 90278-1810
Phone (310) 487-5061

Other identifiers 2

IdentifierTypeStateIssuer
95013683OtherCANURSE PRACTITIONER LICENSE
95013683OtherCANURSE PRACTITIONER FURNISHING LICENSE

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
I20220728001968 CA Practitioner - Nurse Practitioner 6204223019 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carbon Health Medical Group of California PCGroup PAC ID 9032340047, 335 clinicians

Practice addresses (Care Compare)

415 N Pacific Coast Hwy
Suite 101
Redondo Beach, CA 90277
Phone (310) 905-6819

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Friends & Family Medical Clinic, Inc. CurrentSince Apr 19, 2022 Accepting new patients
Marjan Chegounchi MD Inc PastSince Apr 19, 2022 Accepting new patients

Locations

501 E Hardy St
Ste 205
Inglewood, CA 90301
Phone (310) 671-6364

Organizations & group practices 3

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": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1750928388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 ERNEST AVE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902781810",
            "telephone_number": "310-487-5061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W WILLOW ST STE 101",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062831",
            "telephone_number": "562-427-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGUNA",
        "first_name": "LISA",
        "middle_name": "TONELLI",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "491651",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95013683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSE",
            "identifier": "95013683",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER FURNISHING LICENSE",
            "identifier": "95013683",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.