Individual provider Active NPI

Paytyn Laker, CNM, WHNP-BC

  • Advanced Practice Midwife
  • Pacoima, CA
National Provider Identifier
1790500742
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
236490 Issued in CA
Practice address
13721 Pierce St
Pacoima, CA 91331-3742
Phone
(951) 265-1639
NPI assigned
Nov 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 236490 CA Primary
Women's Health Nurse Practitioner 363LW0102X 95032386 CA

Addresses

Primary practice location

13721 Pierce St
Pacoima, CA 91331-3742

Mailing address

13721 Pierce St
Pacoima, CA 91331-3742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250707002165 CA Practitioner - Certified Nurse Midwife (CNM) 4486168143 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
95032386CAMDWomen's Health Nurse Practitioner
236490CAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Valley Medical Group, Inc. Current Accepting new patients
Desert Valley Medical Group, Inc CurrentSince Jun 23, 2025 Accepting new patients
Desert Valley Medical Group, Inc. CurrentSince Jun 23, 2025 Accepting new patients

Locations

16850 Bear Valley Rd
Victorville, CA 92395
Phone (760) 241-8222

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1731628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1790500742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13721 PIERCE ST",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913313742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13721 PIERCE ST",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913313742",
            "telephone_number": "951-265-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKER",
        "first_name": "PAYTYN",
        "credential": "CNM, WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-15",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "236490",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "95032386",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacoima, CA

Sources for this page

Verify at the official NPI Registry.