Edna Karina Favela, R.D., CDE

Primary specialty

Health EducatorTaxonomy code 174H00000X

License

1000367 Issued in CA

Practice address

12168 Mount Vernon Ave Unit 80
Grand Terrace, CA 92313-5545

Phone

(909) 638-3272

NPI assigned

Oct 20, 2015

Last updated

Oct 20, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

{
    "created_epoch": "1445299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445299200000",
    "number": "1871965665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12168 MOUNT VERNON AVE UNIT 80",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135545",
            "telephone_number": "909-638-3272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12168 MOUNT VERNON AVE UNIT 80",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135545",
            "telephone_number": "909-638-3272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVELA",
        "first_name": "EDNA",
        "middle_name": "KARINA",
        "credential": "R.D., CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-20",
        "last_updated": "2015-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "CA",
            "license": "1000367",
            "primary": true
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "CA",
            "license": "21420614",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trisha N Engel
• Equanimity Hospice & Palliative Care, Inc. (Hospice of IE and OC)
• Eric Eschweiler, DNP, RN, FNP-C
• Marisol Espinoza Garcia, ACSW 123201
• Philip Thomas Farabaugh, MD
• Ramon U. Ferra, MD
• Fit Forever Physical Therapy, Inc. (Grand Terrace Physical Therapy)
• Five Oaks Speech Therapy Services PC
• Ashley Fonseca-Tweed, FNP-BC
• Ryan Forgette, M.S. CCC-SLP

• Health Educator in Grand Terrace, CA
• Providers in Grand Terrace, CA by specialty
• Health Educator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2015; 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.