Individual provider Active NPI

Janice Rhea Vertudez, NP

  • Family Nurse Practitioner
  • Concord, CA
National Provider Identifier
1912340118
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22458 Issued in CA
Practice address
3108 Willow Pass Rd
Concord, CA 94519-2325
Phone
(925) 849-6634
Fax
(925) 849-6635
NPI assigned
Apr 8, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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 22458 CA Primary

Addresses

Primary practice location

3108 Willow Pass Rd
Concord, CA 94519-2325

Mailing address

2458 Hilborn Rd
Fairfield, CA 94534-1072
Phone (707) 646-5500

Other names 1

  • Janice Rhea Abila Former name

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
I20141104002332 CA Practitioner - Nurse Practitioner 2062634140 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gurpreet S. Dhugga Medical Corporation CurrentSince May 8, 2018 Accepting new patients
SNF Specialists Medical Corporation CurrentSince Jan 1, 2019 Accepting new patients

Locations

5030 Business Center Dr
Ste 130
Fairfield, CA 94534
Phone (707) 290-5700

1255 Travis Blvd
Fairfield, CA 94533
Phone (707) 425-0623

Organizations & group practices 3

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": "1365379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1912340118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2458 HILBORN RD",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945341072",
            "telephone_number": "707-646-5500",
            "fax_number": "707-646-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3108 WILLOW PASS RD",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945192325",
            "telephone_number": "925-849-6634",
            "fax_number": "925-849-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERTUDEZ",
        "first_name": "JANICE RHEA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-08",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "22458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANICE",
            "last_name": "ABILA",
            "middle_name": "RHEA",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.