Maria Victoria Aquino

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · La Palma, CA

NPI 1881484467 · NPPES record last updated May 8, 2025

Key facts

NPI
1881484467
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
NP95034212 (CA)
Practice address
7811 Jennifer Cir
La Palma, CA 90623-1644
Phone
(310) 808-7985
NPI assigned
May 8, 2025
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ehab Yacoub MD Inc (179 clinicians)

Practice addresses (Care Compare)

1225 W 190TH St
Suite 280
Gardena, CA 90248-4305
Phone (877) 515-8113

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20251001003493 CA Practitioner - Nurse Practitioner 4486150182 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95034212CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ehab Yacoub MD Inc. Current
since Sep 18, 2025
Accepting new patients

Locations

500 La Terraza Blvd
Ste 150
Escondido, CA 92025
Phone (760) 232-6788

1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113

17075 Devonshire St
Ste 204
Northridge, CA 91325
Phone (818) 368-8929

901 W Civic Center Dr
Fl 2
Santa Ana, CA 92703
Phone (951) 216-3549

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP95034212 CA Yes

Addresses

Primary practice location

7811 Jennifer Cir
La Palma, CA 90623-1644

Mailing address

7811 Jennifer Cir
La Palma, CA 90623-1644

Other providers in La Palma, CA

All providers in La Palma, CA · Psychiatric/Mental Health Nurse Practitioner in California

Sources for this page

Verify at the official NPI Registry.