Individual provider Active NPI

Rhealynn Sison Nofuente, FNP-C

  • Family Nurse Practitioner
  • La Mesa, CA
National Provider Identifier
1902279599
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95002795 Issued in CA
Practice address
8851 Center Dr
#408
La Mesa, CA 91942-3017
Phone
(619) 583-1174
NPI assigned
Nov 4, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95002795 CA Primary
Primary Care Nurse Practitioner 363LP2300X 95002795 CA

Addresses

Primary practice location

8851 Center Dr
#408
La Mesa, CA 91942-3017

Mailing address

8851 Center Dr
#408
La Mesa, CA 91942-3017

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
I20160311001032 CA Practitioner - Nurse Practitioner 3274839519 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95002795CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Majid Shahbaz MD Inc CurrentSince Feb 2, 2016 Accepting new patients

Locations

8851 Center Dr
Ste 408
La Mesa, CA 91942
Phone (619) 583-1174

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": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446595200000",
    "number": "1902279599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8851 CENTER DR",
            "address_2": "#408",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8851 CENTER DR",
            "address_2": "#408",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423017",
            "telephone_number": "619-583-1174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOFUENTE",
        "first_name": "RHEALYNN",
        "middle_name": "SISON",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-04",
        "last_updated": "2015-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95002795",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95002795",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.