Igor Gruna Mocorro, DNP, MPH, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95015593 Issued in CA

Practice address

375 Laguna Honda Blvd
San Francisco, CA 94116-1499

Phone

(415) 699-2402

Fax

(415) 682-5668

NPI assigned

Oct 17, 2020

Last updated

Oct 17, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1602892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602892800000",
    "number": "1780283143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 DOLPHIN CT",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941242945",
            "telephone_number": "415-818-5654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 LAGUNA HONDA BLVD",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941161499",
            "telephone_number": "415-699-2402",
            "fax_number": "415-682-5668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCORRO",
        "first_name": "IGOR",
        "middle_name": "GRUNA",
        "name_prefix": "Dr.",
        "credential": "DNP, MPH, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-17",
        "last_updated": "2020-10-17",
        "certification_date": "2020-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95015593",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "765153",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Maryanne Louise Mock, LCSW
• Raymond Peter Moczulski, MD
• Melissa Gisler Modanlou
• Maricris Cudal Model, BCBA
• Modesto Radiological Medical Group, Inc
• Avani Mody, MSW, PPSC

• Family Nurse Practitioner in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.