Andrea Lynne Parker, MSN, RN, CPNP-AC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

NP17208 Issued in CA

Practice address

3030 Childrens Way
San Diego, CA 92123-4232

Phone

(858) 966-8974

NPI assigned

Mar 5, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI, CA2 enrollments

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Regents of the Univ of Ca

  • Maternal & Fetal Medicine Physician
  • Sacramento, CA
  • NPI 1013906973
  Medicare reassignment NPD
• Kapiolani Medical Specialists

  • Multi-Specialty Clinic/Center
  • Honolulu, HI
  • NPI 1124071014
  Medicare reassignment NPD
• Regents of the Univ of Ca

  • Diagnostic Radiology Physician
  • Sacramento, CA
  • NPI 1477546406
  NPD
• Regents of the Univ of Ca

  • Trauma Surgery Physician
  • Sacramento, CA
  • NPI 1568455590
  NPD
• Marilyn Kaufhold, M.D., a Medical Corporation

  • Children's Hospital
  • San Diego, CA
  • NPI 1336359389
  NPD (past)

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

{
    "created_epoch": "1267747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1821311804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5003",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-309-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 CHILDRENS WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234232",
            "telephone_number": "858-966-8974"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2315 Stockton Blvd",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172201",
            "country_code": "US",
            "telephone_number": "916-734-2011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKER",
        "first_name": "ANDREA",
        "middle_name": "LYNNE",
        "name_prefix": "Ms.",
        "credential": "MSN, RN, CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-05",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "NP17208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sun-Yong Park
• Susanna Jung-a Park, MD
• Yeji Esther Park
• Yu Jin Park, RBT
• Parker Wellness Collective, Inc.
• Bailey Parker
• Brenna Parker
• Brittany Parker
• Christine Ann Parker, LPCC
• Christopher Andrew Parker, CRT, RRT

• Pediatric Nurse Practitioner in San Diego, CA
• Providers in San Diego, 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 Dec 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.