Myra Blazo Familara

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

95061272 Issued in CA

Practice address

3050 Montrose Ave
La Crescenta, CA 91214-3619

Phone

(818) 957-0850

Fax

(818) 249-2386

NPI assigned

Mar 26, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522022400000",
    "number": "1952806705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7345 WOODLAND DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462781737",
            "telephone_number": "317-286-2885",
            "fax_number": "317-536-3097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 MONTROSE AVE",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912143619",
            "telephone_number": "818-957-0850",
            "fax_number": "818-249-2386"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7345 Woodland Dr",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462781737",
            "country_code": "US",
            "telephone_number": "317-286-2885",
            "fax_number": "317-536-3097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAMILARA",
        "first_name": "MYRA",
        "middle_name": "BLAZO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2018-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95061272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in La Crescenta, CA
• Providers in La Crescenta, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.