Felicia Carbajal I

Key facts

NPI

1790198653

Entity type

Individual (NPI type 1)

Primary specialty

Rehabilitation Practitioner 225400000X

Practice address

13001 Ramona Blvd
Ste. I
Irwindale, CA 91706-3752

Phone

(626) 337-3828

NPI assigned

Jun 9, 2014

Sex

Female

Sole proprietor

Yes

Organizations & group practices 1

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.

• Pacific Clinics Community/Behavioral Health Agency · Ontario, CA · NPI 1902273923
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 9, 2014.

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402272000000",
    "number": "1790198653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N SAN FERNANDO BLVD",
            "address_2": "APT #335",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915044156",
            "telephone_number": "818-669-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13001 RAMONA BLVD",
            "address_2": "STE. I",
            "city": "IRWINDALE",
            "state": "CA",
            "postal_code": "917063752",
            "telephone_number": "626-337-3828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBAJAL",
        "first_name": "FELICIA",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2014-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Irwindale, CA · Rehabilitation Practitioner in California