Takeisa Denise Crowder, RN, FNP, MSN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP95014666 Issued in CA

Practice address

450 Bauchet St
Los Angeles, CA 90012-2907

Phone

(213) 893-5460

Fax

(213) 217-4854

NPI assigned

Jul 1, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1861019226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4189 5TH AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900083936",
            "telephone_number": "323-381-9940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BAUCHET ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900122907",
            "telephone_number": "213-893-5460",
            "fax_number": "213-217-4854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWDER",
        "first_name": "TAKEISA",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "RN, FNP, MSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-01",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95014666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORRECTIONAL HEALTH SERVICES",
            "identifier": "MC5925435",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORRECTIONAL HEALTH DO NOT BILL",
            "identifier": "NPF95014666",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IT IS A CORRECTIONAL HEALTH FACILITY. WE DO NOT BILL",
            "identifier": "NP95014666",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Computer",
            "affiliation": "N",
            "address_1": "450 Bauchet St",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900122907",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Cerna",
            "affiliation": "N",
            "address_1": "450 Bauchet St",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900122907",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Cerna",
            "affiliation": "N",
            "address_1": "450 Bauchet St",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900122907",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Computer",
            "affiliation": "N",
            "address_1": "450 Bauchet St",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900122907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kenneth L Croutch, MD
• Elizabeth Crow, M.D.
• Patricia Fabiola Crow
• Carla Renea Crowder
• Lionel Crowder
• Christina Foucault Crowe
• Danielle Crowe, LCSW
• Kristen Kerry Crowe
• Catherine Magdalena Crowell
• Crown Care Cranial Prosthetics LLC

• Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.

Verify at the official NPI Registry.