Individual provider Active NPI

Latoya Tia Marie Veliz, FNP, PMHNP

  • Family Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1962064469
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60959949 Issued in WA
Practice address
2621 170TH Street CT E
Tacoma, WA 98445-7328
Phone
(253) 318-1605
NPI assigned
Jul 3, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60959949 WA Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP60959949 WA

Addresses

Primary practice location

2621 170TH Street CT E
Tacoma, WA 98445-7328

Mailing address

2621 170TH Street CT E
Tacoma, WA 98445-7328
Phone (253) 318-1605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20230823003737 WA Practitioner - Nurse Practitioner 2567825565 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60959949WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance for South Sound Health CurrentSince Jul 11, 2023 Accepting new patients

Locations

3402 S 19th St
Tacoma, WA 98405
Phone (253) 301-5400

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": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1962064469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 170TH STREET CT E",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984457328",
            "telephone_number": "253-318-1605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 170TH STREET CT E",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984457328",
            "telephone_number": "253-318-1605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELIZ",
        "first_name": "LATOYA",
        "middle_name": "TIA MARIE",
        "credential": "FNP, PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-03",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60959949",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60959949",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.