Jennifer Ta, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

19921 Issued in CA

Practice address

338 S Dakota Ave BLDG 13850
Lompoc, CA 93437-6307

Phone

(805) 606-2273

NPI assigned

Sep 13, 2012

Sex

Female

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)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner

Practice roles

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.

• Valley Children'S Primary Care Group, Inc.

  • Pediatrics Physician
  • Bakersfield, CA
  • NPI 1760877245
  NPD (past)

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1790035046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 S DAKOTA AVE",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934376307",
            "telephone_number": "805-605-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 S DAKOTA AVE BLDG 13850",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934376307",
            "telephone_number": "805-606-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TA",
        "first_name": "JENNIFER",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-13",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "19921",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "19921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Superior Hospice Inc
• Superior Hospice, Inc.
• Superior Senior Home Care Inc
• Derrick Dewayne Sweat, IDMT- PARAMEDIC
• Christina A Swift
• Mohammad A Tabek Bakir, M.D.
• Brian J Taber, M.D.
• Alexa Tackett, M.S., CCC-SLP
• Christopher Robert Taglia, M.D.
• Danny Michael Takaoka

• Pediatric Nurse Practitioner in Lompoc, CA
• Providers in Lompoc, 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 Mar 30, 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.