Active NPI
Kamilla Rayas Archundia
- Phlebotomy Technician
- Covina, CA
National Provider Identifier
1952190969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebotomy Technician
- License
- CPT-01009543
- Practice address
- 4469 N Broadmoor Ave
Covina, CA 91722-2201 - Phone
- (951) 472-8077
- NPI assigned
- May 5, 2025
- 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 |
|---|---|---|---|---|
| Phlebotomy Technician | 246RP1900X | CPT-01009543 | CA | Primary |
Addresses
Primary practice location
4469 N Broadmoor Ave
Covina, CA 91722-2201
Mailing address
4469 N Broadmoor Ave
Covina, CA 91722-2201
Phone (951) 472-8077
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CPT-01009543 | CA | MD | Phlebotomy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maa Tara LLC | Phlebotomy | Current | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1746403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746489600000",
"number": "1952190969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4469 N BROADMOOR AVE",
"city": "COVINA",
"state": "CA",
"postal_code": "917222201",
"telephone_number": "951-472-8077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4469 N BROADMOOR AVE",
"city": "COVINA",
"state": "CA",
"postal_code": "917222201",
"telephone_number": "951-472-8077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAYAS ARCHUNDIA",
"first_name": "KAMILLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-05",
"last_updated": "2025-05-06",
"certification_date": "2025-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": "CA",
"license": "CPT-01009543",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.