Individual provider Active NPI

Ernestine Jeanest Nepomuceno, FNP

  • Family Nurse Practitioner
  • Whittier, CA
National Provider Identifier
1760115224
Registry record updated Jul 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95019597 Issued in CA
Practice address
4033 Overcrest Dr
Whittier, CA 90601-1787
Phone
(562) 572-4992
NPI assigned
Jul 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 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 NP95019597 CA Primary

Addresses

Primary practice location

4033 Overcrest Dr
Whittier, CA 90601-1787

Mailing address

4033 Overcrest Dr
Whittier, CA 90601-1787
Phone (562) 572-4992

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
I20230821001752 CA Practitioner - Nurse Practitioner 4486016672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Southern California Keck School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael Tehrani MD ApcGroup PAC ID 7810204575, 9 clinicians

Practice addresses (Care Compare)

1703 Termino Ave
Suite 108
Long Beach, CA 90804-2126
Phone (562) 498-2481

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95019597CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Tehrani MD Apc CurrentSince Jul 5, 2023 Accepting new patients

Locations

1703 Termino Ave
Ste 108
Long Beach, CA 90804
Phone (562) 498-2481

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": "1656720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656720000000",
    "number": "1760115224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4033 OVERCREST DR",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906011787",
            "telephone_number": "562-572-4992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4033 OVERCREST DR",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906011787",
            "telephone_number": "562-572-4992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEPOMUCENO",
        "first_name": "ERNESTINE",
        "middle_name": "JEANEST",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-02",
        "last_updated": "2022-07-02",
        "certification_date": "2022-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95019597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.