NPIMap

Organization Active NPI

Prudent Healthcare Services Nursing

  • Internal Medicine Physician
  • Anaheim, CA
National Provider Identifier
1770326969
Registry record updated Jun 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PRUDENT HEALTHCARE SERVICES NURSING
Practice address
421 N Brookhurst St Ste 228C
Anaheim, CA 92801-5619
Phone
(562) 306-9739
NPI assigned
Jun 15, 2024
Last updated
Jun 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2024

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

Authorized official

Name
Ava Salarda, NP
Title
Owner
Phone
(562) 306-9739

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary
Nurse Practitioner 363L00000X NU

Addresses

Primary practice location

421 N Brookhurst St Ste 228C
Anaheim, CA 92801-5619

Mailing address

421 N Brookhurst St Ste 228C
Anaheim, CA 92801-5619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240829002719 CA Part B Supplier - Clinic/Group Practice 7113466533 Receives reassigned benefits from 18 practitioners
Practice locations: Anaheim, CA

National Provider Directory

National Provider Directory

Locations

421 N Brookhurst St
Ste 224
Anaheim, CA 92801
Phone (562) 306-9739

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1718409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718409600000",
    "number": "1770326969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 N BROOKHURST ST STE 228C",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928015619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 N BROOKHURST ST STE 228C",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928015619",
            "telephone_number": "562-306-9739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUDENT HEALTHCARE SERVICES NURSING",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-15",
        "last_updated": "2024-06-15",
        "certification_date": "2024-06-14",
        "status": "A",
        "authorized_official_last_name": "SALARDA",
        "authorized_official_first_name": "AVA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-306-9739",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.