Individual provider Active NPI

Rachel La Madrid Balbas-Go, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Sylmar, CA
National Provider Identifier
1891833216
Registry record updated Jan 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP23011 Issued in CA
Practice address
14659 Olive View Dr
Sylmar, CA 91342-1652
Phone
(818) 485-0888
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 541990 CA
Rehabilitation Practitioner 225400000X 541990 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP23011 CA Primary

Addresses

Primary practice location

14659 Olive View Dr
Sylmar, CA 91342-1652

Mailing address

659 E Gardenia Dr
Azusa, CA 91702-6296
Phone (626) 812-0497

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
I20170523002655 CA Practitioner - Nurse Practitioner 5890062822 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23011CAMDDentist
541990CAMDRehabilitation Practitioner
NP23011CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Wellness Partners Psychiatric/Mental Health CurrentSince Jan 1, 2023 Accepting new patients

Locations

820 N Mountain Ave
Ste 215
Upland, CA 91786
Phone (844) 467-3867

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.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389916800000",
    "number": "1891833216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 E GARDENIA DR",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917026296",
            "telephone_number": "626-812-0497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14659 OLIVE VIEW DR",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421652",
            "telephone_number": "818-485-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALBAS-GO",
        "first_name": "RACHEL",
        "middle_name": "LA MADRID",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2014-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "541990",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": "541990",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP23011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

Verify at the official NPI Registry.