Kaitlynn Menjo, NP, RN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

95015021 Issued in CA

Practice address

808 W 58TH St
Los Angeles, CA 90037-3632

Phone

(323) 541-1600

NPI assigned

Oct 14, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kaitlynn Estes Other name

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, Registered Nurse

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• St. Johns Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1073653630
  Medicare reassignment NPD
• St. Johns Community Health

  • Community Health Clinic/Center
  • Los Angeles, CA
  • NPI 1073363768
  NPD
• St. Johns Community Health

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1780376947
  NPD (past)

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1942808654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4803 HERSHOLT AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 W 58TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900373632",
            "telephone_number": "323-541-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENJO",
        "first_name": "KAITLYNN",
        "credential": "NP, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-14",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95015021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYNN",
            "last_name": "ESTES",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Genesis Menjivar
• Janeri Fabiola Menjivar
• Karla Iliana Menjivar, FNP
• Silvia Menjivar
• William Menjivar
• Kerry Menmuir, PHARM.D.
• Carrianne Menna
• Madhavi Menon
• Vyshnav Rajagopal Menon, M.D
• Christina Marie Menor, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.