Individual provider Active NPI

Georgina Bachoura, MSN, APRN, FNP

  • Family Nurse Practitioner
  • San Fernando, CA
National Provider Identifier
1760746242
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21860 Issued in CA
Practice address
1600 San Fernando Rd
San Fernando, CA 91340-3115
Phone
(818) 896-0531
NPI assigned
Jun 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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 21860 CA Primary

Addresses

Primary practice location

1600 San Fernando Rd
San Fernando, CA 91340-3115

Mailing address

1600 San Fernando Rd
San Fernando, CA 91340-3115
Phone (818) 896-0531

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
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
21860CAMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Advanced Nursing, Inc. Family Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: georgina.bachoura.p1@direct.nevhc.nextgenshare.com

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": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1760746242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SAN FERNANDO RD",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913403115",
            "telephone_number": "818-896-0531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SAN FERNANDO RD",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913403115",
            "telephone_number": "818-896-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACHOURA",
        "first_name": "GEORGINA",
        "name_prefix": "Ms.",
        "credential": "MSN, APRN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-28",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "21860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Fernando, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.