Active NPI
Devine Ndikwa
- Family Nurse Practitioner
- Los Angeles, CA
National Provider Identifier
1780108878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95005666
- Practice address
- 3111 Los Feliz Blvd Ste 211
Los Angeles, CA 90039-1585 - Phone
- (866) 227-3310
- Fax
- (866) 491-1305
- NPI assigned
- Jul 31, 2017
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95005666 | CA | Primary |
Addresses
Primary practice location
3111 Los Feliz Blvd Ste 211
Los Angeles, CA 90039-1585
Mailing address
9440 Rose St
Bellflower, CA 90706-6529
Phone (310) 995-5620
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
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501459200000",
"number": "1780108878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9440 ROSE ST",
"city": "BELLFLOWER",
"state": "CA",
"postal_code": "907066529",
"telephone_number": "310-995-5620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3111 LOS FELIZ BLVD STE 211",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900391585",
"telephone_number": "866-227-3310",
"fax_number": "866-491-1305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NDIKWA",
"first_name": "DEVINE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-31",
"last_updated": "2017-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95005666",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.