Individual provider Active NPI

Andrea Morinoue

  • Student in an Organized Health Care Education/Training Program
  • Escondido, CA
National Provider Identifier
1902335532
Registry record updated Jun 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
125 W Mission Ave Ste 103
Escondido, CA 92025-1721
Phone
(760) 747-3424
Fax
(760) 747-3435
NPI assigned
Jun 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA Primary

Addresses

Primary practice location

125 W Mission Ave Ste 103
Escondido, CA 92025-1721

Mailing address

1851 Saint Lucia Way
Vista, CA 92081-7042
Phone (858) 699-0431

Other names 1

  • Andrea M Davis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 30, 2025 through Jan 30, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496793600000",
    "number": "1902335532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 SAINT LUCIA WAY",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920817042",
            "telephone_number": "858-699-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W MISSION AVE STE 103",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920251721",
            "telephone_number": "760-747-3424",
            "fax_number": "760-747-3435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORINOUE",
        "first_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-07",
        "last_updated": "2017-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "DAVIS",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.