Individual provider Active NPI

Jacqueline J Guinn, M.D.

  • Pediatrics Physician
  • Mission Hills, CA
National Provider Identifier
1932234887
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A77734 Issued in CA
Practice address
11333 Sepulveda Blvd
Mission Hills, CA 91345-1116
Phone
(818) 365-9531
NPI assigned
Feb 22, 2007
Last updated
Oct 15, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A77734 CA Primary

Addresses

Primary practice location

11333 Sepulveda Blvd
Mission Hills, CA 91345-1116

Mailing address

PO Box 9602
Mission Hills, CA 91346-9602
Phone (818) 837-5559

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040414001873 CA Practitioner - Pediatric Medicine 5890780423 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A77734CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Ventura Current Accepting new patients
County of Ventura CurrentSince Mar 11, 2015 Accepting new patients
County of Ventura CurrentSince Mar 11, 2015 Accepting new patients
Providence Facey Medical Foundation Past Accepting new patients
Mission City Community Network,Inc Past Accepting new patients

Locations

1227 E Los Angeles Ave
Simi Valley, CA 93065
Phone (805) 582-4000

300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000

800 S Victoria Ave
#L4640
Ventura, CA 93009

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1932234887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9602",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913469602",
            "telephone_number": "818-837-5559",
            "fax_number": "818-792-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11333 SEPULVEDA BLVD",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451116",
            "telephone_number": "818-365-9531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUINN",
        "first_name": "JACQUELINE",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A77734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Hills, CA

Sources for this page

Verify at the official NPI Registry.