Active NPI
Geraldin Dedios
- Community Health Worker
- Lancaster, CA
National Provider Identifier
1821508623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- E2853560
- Practice address
- 43909 30TH St W
Lancaster, CA 93536-5843 - Phone
- (661) 952-5000
- NPI assigned
- Oct 5, 2017
- Last updated
- Oct 5, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | E2853560 | CA | Primary |
Addresses
Primary practice location
43909 30TH St W
Lancaster, CA 93536-5843
Mailing address
38032 5TH St E Apt 30
Palmdale, CA 93550-2306
Phone (661) 450-5349
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E2853560 | CA | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507161600000",
"number": "1821508623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38032 5TH ST E APT 30",
"city": "PALMDALE",
"state": "CA",
"postal_code": "935502306",
"telephone_number": "661-450-5349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43909 30TH ST W",
"city": "LANCASTER",
"state": "CA",
"postal_code": "935365843",
"telephone_number": "661-952-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEDIOS",
"first_name": "GERALDIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-05",
"last_updated": "2017-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "CA",
"license": "E2853560",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lancaster, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.