Katherine Rae Angeles, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

95015701 Issued in CA

Practice address

1720 Mountain View Ave
Loma Linda, CA 92354-1727

Phone

(909) 796-6915

NPI assigned

Jan 29, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Katie Angeles Other name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kangeles335139@direct.llu.edu

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.

• Faculty Physicians and Surgeons of Llusm

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  • Apple Valley, CA
  • NPI 1205009917
  Medicare reassignment NPD
• Faculty Physicians and Surgeons of Llusm

  • Pediatrics Physician
  • Highland, CA
  • NPI 1689624991
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Urology Physician
  • Loma Linda, CA
  • NPI 1790326825
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Orthopaedic Surgery Physician
  • Loma Linda, CA
  • NPI 1275582918
  NPD (past)

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1780215699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11524 CHAPMAN AVE",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543954",
            "telephone_number": "909-725-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 MOUNTAIN VIEW AVE",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923541727",
            "telephone_number": "909-796-6915"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11524 Chapman Ave",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923543954",
            "country_code": "US",
            "telephone_number": "909-725-4288",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "26520 Cactus Ave",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925553927",
            "country_code": "US",
            "telephone_number": "951-486-5450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANGELES",
        "first_name": "KATHERINE",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95015701",
            "primary": true
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "CA",
            "license": "818775",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "ANGELES",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Candace Andrews
• Michael Andrews
• Jordan Aney, M.D.
• Carmen Ysabel Poe Ang, MD
• Lana P Ang, NP
• Matthew Angkadjaja
• Katia Angulo
• James D. Anholm, M.D.
• Nayo Euphemia Animasaun
• Annessa Du, O.D., a Professional Corporation

• Pediatric Nurse Practitioner in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.