Active NPI
Maryanne Dillon, NP
- Women's Health Nurse Practitioner
- Los Angeles, CA
National Provider Identifier
1942597737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 3895
- Practice address
- 10833 Le Conte Ave
UCLA Peds I.D.- RM 22-442 MDCC,
Los Angeles, CA 90095-1752 - Phone
- (310) 206-6369
- Fax
- (310) 825-9175
- NPI assigned
- Jun 30, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 3895 | CA | Primary |
Addresses
Primary practice location
10833 Le Conte Ave
UCLA Peds I.D.- RM 22-442 MDCC,
Los Angeles, CA 90095-1752
Mailing address
10833 Le Conte Ave
UCLA Peds I.D.- RM 22-442 MDCC,
Los Angeles, CA 90095-1752
Phone (310) 206-6369
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3895 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309392000000",
"number": "1942597737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10833 LE CONTE AVE",
"address_2": "UCLA PEDS I.D.- RM 22-442 MDCC,",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900951752",
"telephone_number": "310-206-6369",
"fax_number": "310-825-9175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10833 LE CONTE AVE",
"address_2": "UCLA PEDS I.D.- RM 22-442 MDCC,",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900951752",
"telephone_number": "310-206-6369",
"fax_number": "310-825-9175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLON",
"first_name": "MARYANNE",
"name_prefix": "Ms.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-30",
"last_updated": "2011-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "CA",
"license": "3895",
"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 Jun 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.