Individual provider Active NPI

Autumn Sunshine Houston, FNP

  • Primary Care Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1881454726
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
NP95027181 Issued in CA
Practice address
5425 Camino Santander Apt 30
San Diego, CA 92130-6536
Phone
(619) 944-8236
NPI assigned
Mar 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X NP95027181 CA Primary

Addresses

Primary practice location

5425 Camino Santander Apt 30
San Diego, CA 92130-6536

Mailing address

5425 Camino Santander Apt 30
San Diego, CA 92130-6536
Phone (619) 944-8236

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
I20240725000862 CA Practitioner - Nurse Practitioner 5991241085 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95027181CAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Care CurrentSince Jan 6, 2025 Accepting new patients
La Maestra Family Clinic, Inc. CurrentSince Feb 7, 2025 Accepting new patients
Central Health Plan of California, Inc. CurrentSince Jan 6, 2025 Accepting new patients
Molina Healthcare of California CurrentSince Jan 6, 2025 Accepting new patients
La Maestra Family Clinic, Inc. CurrentSince Feb 7, 2025 Accepting new patients
La Maestra Family Clinic, Inc. Current Accepting new patients
La Maestra Family Clinic Past Accepting new patients

Locations

165 S 1st St
El Cajon, CA 92019
Phone (619) 312-0347

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

4074 Fairmount Ave
San Diego, CA 92105
Phone (619) 284-1141

4060 Fairmount Ave
San Diego, CA 92105
Phone (619) 255-9155

Interoperability endpoints

  • Direct secure messaging: autumn.houston.p1@direct.lamaestra.nextgenshare.com

Organizations & group practices 7

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": "1710806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1881454726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 CAMINO SANTANDER APT 30",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921306536",
            "telephone_number": "619-944-8236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 CAMINO SANTANDER APT 30",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921306536",
            "telephone_number": "619-944-8236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSTON",
        "first_name": "AUTUMN",
        "middle_name": "SUNSHINE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "NP95027181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.