Individual provider Active NPI

Rosa Salas, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1932783594
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95017006 Issued in CA
Practice address
605 N Mednik Ave
Los Angeles, CA 90022-1326
Phone
(323) 526-2880
Fax
(323) 526-2885
NPI assigned
May 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95017006 CA Primary

Addresses

Primary practice location

605 N Mednik Ave
Los Angeles, CA 90022-1326

Mailing address

5978 Gardendale St
South Gate, CA 90280-7901
Phone (562) 889-2618

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

State licenses

LicenseStateTypeSpecialty
95017006CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1932783594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5978 GARDENDALE ST",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902807901",
            "telephone_number": "562-889-2618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 N MEDNIK AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221326",
            "telephone_number": "323-526-2880",
            "fax_number": "323-526-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAS",
        "first_name": "ROSA",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-10",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.