Individual provider Active NPI

Jan Matthew Ravina Angeles, NP

  • Nurse Practitioner
  • Van Nuys, CA
National Provider Identifier
1942989801
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95025746 Issued in CA
Practice address
6815 Noble Ave
Van Nuys, CA 91405-3796
Phone
(818) 901-6600
NPI assigned
Jul 17, 2023
Last updated
Sep 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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 95025746 CA Primary

Addresses

Primary practice location

6815 Noble Ave
Van Nuys, CA 91405-3796

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

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
I20250717002716 CA Practitioner - Nurse Practitioner 8123534112 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 UCLA Medical PLZ
Suite 460
Los Angeles, CA 90024-7000
Phone (310) 443-8999

24051 Newhall Ranch Rd
BLDG C
Valencia, CA 91355-5702
Phone (661) 254-6364

30870 Russell Ranch Rd
Suite 330
Westlake Village, CA 91362-7347
Phone (805) 497-7015

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95025746CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Sep 1, 2025 Accepting new patients
Regents of the University of California CurrentSince Sep 1, 2025 Accepting new patients
Regents of the University of California Current Accepting new patients

Locations

5201 Truxtun Ave
Bakersfield, CA 93309
Phone (661) 328-5565

100 UCLA Medical Plz
Ste 460
Los Angeles, CA 90024
Phone (310) 443-8999

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

2655 1st St
Ste 300
Simi Valley, CA 93065
Phone (805) 578-8550

6815 Noble Ave
Van Nuys, CA 91405
Phone (818) 901-6690

Interoperability endpoints

  • Direct secure messaging: jangeles1442534@direct.uclahealth.org

Organizations & group practices 3

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1942989801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6815 NOBLE AVE",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053796",
            "telephone_number": "818-901-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELES",
        "first_name": "JAN MATTHEW",
        "middle_name": "RAVINA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-17",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95025746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.