Individual provider Active NPI

Brenda Guadiana, NP

  • Nurse Practitioner
  • East Los Angeles, CA
National Provider Identifier
1932852084
Registry record updated Jan 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95019089 Issued in CA
Practice address
4755 E Cesar E Chavez Ave
East Los Angeles, CA 90022-1267
Phone
(323) 268-9191
NPI assigned
Jan 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95019089 CA Primary

Addresses

Primary practice location

4755 E Cesar E Chavez Ave
East Los Angeles, CA 90022-1267

Mailing address

613 Leonard Ave
Los Angeles, CA 90022-3507

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240723000342 CA Practitioner - Nurse Practitioner 4486190832 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Via Care Community Health Center CurrentSince Jun 5, 2024 Accepting new patients
Via Care Community Health Center CurrentSince Jun 5, 2024 Accepting new patients

Locations

4755 E Cesar E Chavez Ave
Los Angeles, CA 90022
Phone (323) 262-4194

507 S Atlantic Blvd
Los Angeles, CA 90022
Phone 32326891911067

501 S Atlantic Blvd
Los Angeles, CA 90022
Phone (323) 268-5442

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1643414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643414400000",
    "number": "1932852084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 LEONARD AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900223507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 E CESAR E CHAVEZ AVE",
            "city": "EAST LOS ANGELES",
            "state": "CA",
            "postal_code": "900221267",
            "telephone_number": "323-268-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUADIANA",
        "first_name": "BRENDA",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-29",
        "last_updated": "2022-01-29",
        "certification_date": "2022-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95019089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.