Active NPI
Fidelis Nwaki
- Psychiatric/Mental Health Registered Nurse
- View Park, CA
National Provider Identifier
1922422856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Registered Nurse
- License
- 626239
- Practice address
- 3741 Stocker St
View Park, CA 90008-5109 - Phone
- (213) 507-0814
- NPI assigned
- Feb 12, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 626239 | CA | Primary |
Addresses
Primary practice location
3741 Stocker St
View Park, CA 90008-5109
Mailing address
3741 Stocker St
View Park, CA 90008-5109
Phone (213) 507-0814
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 626239 | CA | MD | Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617667200000",
"number": "1922422856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3741 STOCKER ST",
"city": "VIEW PARK",
"state": "CA",
"postal_code": "900085109",
"telephone_number": "213-507-0814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3741 STOCKER ST",
"city": "VIEW PARK",
"state": "CA",
"postal_code": "900085109",
"telephone_number": "213-507-0814"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NWAKI",
"first_name": "FIDELIS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-02-12",
"last_updated": "2021-04-06",
"certification_date": "2021-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "CA",
"license": "626239",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in View Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.