Active NPI
Deirdre Degenaar, CNM, WHNP
- Registered Nurse
- Chino, CA
National Provider Identifier
1922514504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 520579
- Practice address
- 15962 Moonflower Ave
Chino, CA 91708 - Phone
- (909) 287-3312
- NPI assigned
- Dec 19, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | CA | ||
| Women's Health Nurse Practitioner | 363LW0102X | 95008003 | CA | |
| Registered Nurse | 163W00000X | 520579 | CA | Primary |
Addresses
Primary practice location
15962 Moonflower Ave
Chino, CA 91708
Mailing address
15962 Moonflower Ave
Chino, CA 91708
Phone (909) 287-3312
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
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 520579 | CA | MD | Registered Nurse |
| 95008003 | CA | MD | Women's Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1922514504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15962 MOONFLOWER AVE",
"city": "CHINO",
"state": "CA",
"postal_code": "91708",
"telephone_number": "909-287-3312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15962 MOONFLOWER AVE",
"city": "CHINO",
"state": "CA",
"postal_code": "91708",
"telephone_number": "909-287-3312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEGENAAR",
"first_name": "DEIRDRE",
"name_prefix": "Miss",
"credential": "CNM, WHNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-19",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "CA",
"license": "95008003",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "520579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.