Individual provider Active NPI

Ferdinand Gonzales Lacurom, MSN-FNP, BSP, FNP-C

  • Family Nurse Practitioner
  • Chula Vista, CA
National Provider Identifier
1902227655
Registry record updated Dec 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95000164 Issued in CA
Practice address
1313 Blue Sage Way
Chula Vista, CA 91915-1616
Phone
(619) 947-6418
NPI assigned
Dec 25, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95000164 CA Primary

Addresses

Primary practice location

1313 Blue Sage Way
Chula Vista, CA 91915-1616

Mailing address

1313 Blue Sage Way
Chula Vista, CA 91915-1616
Phone (619) 947-6418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95000164CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1387929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387929600000",
    "number": "1902227655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 BLUE SAGE WAY",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919151616",
            "telephone_number": "619-947-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 BLUE SAGE WAY",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919151616",
            "telephone_number": "619-947-6418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACUROM",
        "first_name": "FERDINAND",
        "middle_name": "GONZALES",
        "name_prefix": "Mr.",
        "credential": "MSN-FNP, BSP, FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-25",
        "last_updated": "2013-12-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95000164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.