Individual provider Active NPI

Katriel Ortega Dubongco

  • Family Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1912627183
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F08220312 Issued in CA
Practice address
1703 Termino Ave Ste 206
Long Beach, CA 90804-2128
Phone
(562) 961-0210
NPI assigned
Aug 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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 F08220312 CA Primary

Addresses

Primary practice location

1703 Termino Ave Ste 206
Long Beach, CA 90804-2128

Mailing address

7675 Mission Valley Rd
San Diego, CA 92108-4429
Phone (800) 316-6314

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
F08220312CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1912627183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7675 MISSION VALLEY RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084429",
            "telephone_number": "800-316-6314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 TERMINO AVE STE 206",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908042128",
            "telephone_number": "562-961-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTEGA DUBONGCO",
        "first_name": "KATRIEL",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "F08220312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.