Tina Huttayasomboon, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

21685 Issued in CA

Practice address

1100 N State St
Los Angeles, CA 90033-5000

Phone

(323) 409-7791

NPI assigned

Aug 5, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1375660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392768000000",
    "number": "1942632609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N STATE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "323-409-7791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N STATE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335000",
            "telephone_number": "323-409-7791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTTAYASOMBOON",
        "first_name": "TINA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-05",
        "last_updated": "2014-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "21685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Hutchison, PH.D., M.F.T.
• Megan E Huth
• Theodore Michael Hutman, PH.D.
• Russell Hutson, MD
• Kiondre Hutt
• Andrea Salzman Hutter, L.AC.
• Miriam Golda Zehava Huttler
• Courtney Hutton, A.S.W.
• Debora Hutton
• Hannelore Hutton, LMFT

• Family Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.