Active NPI
Rebecca Lynn Tidwell Prediletto, CNM
- Midwife
- South Pasadena, CA
National Provider Identifier
1851558696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 222
- Practice address
- 1416 El Centro St
South Pasadena, CA 91030-3202 - Phone
- (626) 577-2229
- NPI assigned
- May 20, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Midwife | 176B00000X | 222 | CA | Primary |
Addresses
Primary practice location
1416 El Centro St
South Pasadena, CA 91030-3202
Mailing address
2489 Loy LN
Los Angeles, CA 90041-1817
Phone (213) 923-4042
Other practice location 1
1820 Montrose St
Los Angeles, CA 90026-4110
Phone (213) 923-4042
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
- Credentials
- Certified Nurse Midwife
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588291200000",
"number": "1851558696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2489 LOY LN",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900411817",
"telephone_number": "213-923-4042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1416 EL CENTRO ST",
"city": "SOUTH PASADENA",
"state": "CA",
"postal_code": "910303202",
"telephone_number": "626-577-2229"
}
],
"practiceLocations": [
{
"address_1": "1820 Montrose St",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900264110",
"country_code": "US",
"telephone_number": "213-923-4042",
"fax_number": "213-353-9840",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PREDILETTO",
"first_name": "REBECCA",
"middle_name": "LYNN TIDWELL",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-20",
"last_updated": "2020-05-01",
"certification_date": "2020-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "CA",
"license": "222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.