Active NPI
Monica L Waterloo, PA-C
- Physician Assistant
- Irvine, CA
National Provider Identifier
1932434115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 51790
- Practice address
- 501 Student Health
Irvine, CA 92697-5200 - Phone
- (949) 824-5301
- NPI assigned
- Oct 6, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | TMA052174 | PA | |
| Physician Assistant | 363A00000X | 51790 | CA | Primary |
Addresses
Primary practice location
501 Student Health
Irvine, CA 92697-5200
Mailing address
501 Student Health
Irvine, CA 92697-5200
Phone (949) 824-5301
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51790 | CA | MD | Physical Therapy Assistant |
| TMA052174 | PA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654560000000",
"number": "1932434115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 STUDENT HEALTH",
"city": "IRVINE",
"state": "CA",
"postal_code": "926975200",
"telephone_number": "949-824-5301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 STUDENT HEALTH",
"city": "IRVINE",
"state": "CA",
"postal_code": "926975200",
"telephone_number": "949-824-5301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERLOO",
"first_name": "MONICA",
"middle_name": "L",
"name_prefix": "Miss",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-06",
"last_updated": "2022-06-07",
"certification_date": "2022-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "TMA052174",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "51790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.