Individual provider Active NPI

Ashley Beth Ciccarello, FNP-BC

  • Family Nurse Practitioner
  • Canyon Country, CA
National Provider Identifier
1801368626
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95010703 Issued in CA
Practice address
14550 Soledad Canyon Rd
Canyon Country, CA 91387-2200
Phone
(661) 250-5200
NPI assigned
Dec 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95010703 CA Primary

Addresses

Primary practice location

14550 Soledad Canyon Rd
Canyon Country, CA 91387-2200

Mailing address

PO Box 9602
Mission Hills, CA 91346-9602
Phone (818) 837-5559

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190628000886 CA Practitioner - Nurse Practitioner 7911231634 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11333 Sepulveda Blvd
Mission Hills, CA 91345-1116
Phone (818) 365-9531

14550 Soledad Canyon Rd
Canyon Country, CA 91387-2200
Phone (661) 250-5200

19950 Rinaldi St
Porter Ranch, CA 91326-4141
Phone (818) 403-2400

26357 McBean Pkwy
Valencia, CA 91355-4488
Phone (661) 222-2600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95010703CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation Current Accepting new patients
Providence Facey Medical Foundation CurrentSince Aug 9, 2021 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince May 28, 2019 Accepting new patients
Healthcare Partners Affiliates Medical Group Current Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince May 28, 2019 Accepting new patients
Providence Facey Medical Foundation CurrentSince Aug 9, 2021 Accepting new patients
Minuteclinic Diagnostic Medical Group of California Inc Family CurrentSince Apr 14, 2021 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

1401 S Baldwin Ave
Arcadia, CA 91007
Phone (626) 321-4210

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

File 50670
Los Angeles, CA 90074

13171 Mindanao Way
Marina del Rey, CA 90292
Phone (310) 222-5665

18460 Roscoe Blvd
Northridge, CA 91325
Phone (818) 734-3600

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

1900 19th Ave
San Francisco, CA 94116
Phone (415) 664-1834

14550 Soledad Canyon Rd
Santa Clarita, CA 91387
Phone (661) 250-5200

2791 Agoura Rd
Westlake Village, CA 91361
Phone 8054954938 ext. 8221

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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": "1545091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1801368626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9602",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913469602",
            "telephone_number": "818-837-5559",
            "fax_number": "818-792-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14550 SOLEDAD CANYON RD",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "913872200",
            "telephone_number": "661-250-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCARELLO",
        "first_name": "ASHLEY",
        "middle_name": "BETH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-18",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95010703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canyon Country, CA

Sources for this page

Verify at the official NPI Registry.