Active NPI
Mattiana Susana NG, CNM
- Advanced Practice Midwife
- Glendale, CA
National Provider Identifier
1932225976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- 878
- Practice address
- 1420 S Central Ave
Glendale, CA 91204-2508 - Phone
- (818) 502-4567
- Fax
- (818) 502-4568
- NPI assigned
- Mar 21, 2007
- Last updated
- May 31, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN425028 | CA | |
| Advanced Practice Midwife | 367A00000X | 878 | CA | Primary |
Addresses
Primary practice location
1420 S Central Ave
Glendale, CA 91204-2508
Mailing address
24307 Magic Mountain Parkway
Suite #145
Valencia, CA 91355-1808
Phone (661) 618-4277
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)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 878 | CA | MD | Professional Counselor |
| 17808 | CA | MD | Speech-Language Pathologist |
| RN425028 | CA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496188800000",
"number": "1932225976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24307 MAGIC MOUNTAIN PARKWAY",
"address_2": "SUITE #145",
"city": "VALENCIA",
"state": "CA",
"postal_code": "913551808",
"telephone_number": "661-618-4277",
"fax_number": "760-646-9719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1420 S CENTRAL AVE",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912042508",
"telephone_number": "818-502-4567",
"fax_number": "818-502-4568"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NG",
"first_name": "MATTIANA",
"middle_name": "SUSANA",
"credential": "CNM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-21",
"last_updated": "2017-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "RN425028",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "CA",
"license": "878",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.