Individual provider Active NPI

Ranita Hahm, NP

  • Adult Health Nurse Practitioner
  • Palmdale, CA
National Provider Identifier
1881058188
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
95003546 Issued in CA
Practice address
1101 Lockheed Way
Palmdale, CA 93599-4201
Phone
(323) 376-7113
NPI assigned
Apr 12, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95003546 CA
Adult Health Nurse Practitioner 363LA2200X 95003546 CA Primary

Addresses

Primary practice location

1101 Lockheed Way
Palmdale, CA 93599-4201

Mailing address

710 Crenshaw Blvd Apt 101
Los Angeles, CA 90005-3687
Phone (323) 376-7113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230511002382 CA Practitioner - Nurse Practitioner 3375909609 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bixby Mental Health IncGroup PAC ID 4385098458, 4 clinicians

Practice addresses (Care Compare)

600 S San Vicente Blvd
Suite 100
Los Angeles, CA 90048-4664
Phone (310) 873-3312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95003546CAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geri Connection CurrentSince Apr 1, 2023 Accepting new patients
Myndfull Care Management California PC CurrentSince Apr 1, 2023 Accepting new patients
Managedmed Inc., a Psychological Corporation Past Accepting new patients

Locations

15644 Pomerado Rd
Ste 202
Poway, CA 92064
Phone (619) 320-8090

8445 Camino Santa Fe
Ste 215
San Diego, CA 92121
Phone (619) 541-3246

9436 W Lake Mead Blvd
Ste 5
Las Vegas, NV 89134
Phone (702) 328-7648

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1881058188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 CRENSHAW BLVD APT 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900053687",
            "telephone_number": "323-376-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 LOCKHEED WAY",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935994201",
            "telephone_number": "323-376-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAHM",
        "first_name": "RANITA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-12",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95003546",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95003546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

Verify at the official NPI Registry.