Yucca Valley Medical Clinic

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

Legal business name

YUCCA VALLEY MEDICAL CLINIC

Practice address

57370 29 Palms Hwy Ste 203
Yucca Valley, CA 92284-2900

Phone

(760) 369-8200

NPI assigned

Aug 25, 2023

Last updated

Aug 30, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Heidi Horning

Title

Credentialer

Phone

(707) 299-7043

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matt Gabriel Moran, N.P.

  • Adult Health Nurse Practitioner
  • Yucca Valley, CA
  • NPI 1043525587
  Medicare reassignment NPD
• Juan M. Acosta, MD

  • Pediatric Surgery Physician
  • Phoenix, AZ
  • NPI 1467423772

  CA

  Medicare reassignment NPD

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

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693353600000",
    "number": "1952186322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57370 29 PALMS HWY STE 203",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922842900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57370 29 PALMS HWY STE 203",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922842900",
            "telephone_number": "760-369-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YUCCA VALLEY MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A",
        "authorized_official_last_name": "HORNING",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_title_or_position": "CREDENTIALER",
        "authorized_official_telephone_number": "707-299-7043"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yucca Family Medical Care, Inc.
• Yucca Family Medical Care, Inc.
• Yucca Valley Congregate Living LLC
• Yucca Valley Family Medical Associates, Inc.
• Yucca Valley Fire District
• Yucca Valley Urgent Care, Inc. (Avalon Urgent Care)
• Rebecca Zabala
• Randee Zeller Argirakis
• Yizhou Zheng, PHARMD
• Chrix Jodek Zzyzx, AMFT

• Pediatric Surgery Physician in Yucca Valley, CA
• Providers in Yucca Valley, CA by specialty
• Pediatric Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.