Individual provider Active NPI

Azucena Becerra

  • Certified Registered Nurse Anesthetist
  • Fontana, CA
National Provider Identifier
1891476958
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95002174 Issued in CA
Practice address
9961 Sierra Ave
Fontana, CA 92335-6720
Phone
(833) 574-2273
NPI assigned
Jul 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 95002174 CA Primary
Registered Nurse 163W00000X 95075915 CA

Addresses

Primary practice location

9961 Sierra Ave
Fontana, CA 92335-6720

Mailing address

275 E Green St Apt 1333
Pasadena, CA 91101-4417

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240326003900 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3274970272 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Healthcare Partners PCGroup PAC ID 2163606807, 232 clinicians
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

10 Congress St
Suite 410
Pasadena, CA 91105-3023
Phone (626) 412-2838

9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Amsurg Arcadia Anesthesia LP CurrentSince Mar 16, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Genesis Healthcare Partners PC CurrentSince Jul 4, 2025 Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 15, 2024 Accepting new patients
Glendora Anesthesia Associates LP Nurse Anesthetist, Certified Registered CurrentSince May 11, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 15, 2024 Accepting new patients

Locations

488 E Santa Clara St
Ste 102
Arcadia, CA 91006
Phone (626) 359-9555

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

1794 S Barranca Ave
Glendora, CA 91740
Phone (626) 858-4600

9850 Genesee Ave
Ste 440
La Jolla, CA 92037
Phone (858) 453-5944

10 Congress St
Ste 410
Pasadena, CA 91105
Phone (626) 412-2838

1A Burton Hills Blvd
Nashville, TN 37215
Phone (615) 263-5579

Organizations & group practices 6

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": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1891476958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 E GREEN ST APT 1333",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911014417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9961 SIERRA AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356720",
            "telephone_number": "833-574-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECERRA",
        "first_name": "AZUCENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95002174",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95075915",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.