Active NPI
Lynn Ellen Marony, CPNP
- Pediatric Nurse Practitioner
- Garden Grove, CA
National Provider Identifier
1770780231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 290698
- Practice address
- 12100 Euclid St
Garden Grove, CA 92840-3304 - Phone
- (714) 741-3580
- NPI assigned
- Jun 28, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 290698 | CA | Primary |
Addresses
Primary practice location
12100 Euclid St
Garden Grove, CA 92840-3304
Mailing address
1665 Scenic Ave.
Suite 100
Costa Mesa, CA 92626
Phone (714) 846-2647
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)
- Enrolled
- Credentials
- Certified Pediatric Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6239 | CA | MD | Optometrist |
Interoperability endpoints
- lynn.marony.p1@direct.lakeside.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354665600000",
"number": "1770780231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1665 SCENIC AVE.",
"address_2": "SUITE 100",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "92626",
"telephone_number": "714-846-2647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12100 EUCLID ST",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928403304",
"telephone_number": "714-741-3580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARONY",
"first_name": "LYNN",
"middle_name": "ELLEN",
"credential": "CPNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-28",
"last_updated": "2012-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CA",
"license": "290698",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.