Reena Devaraj

Primary specialty

SpecialistTaxonomy code 174400000X

License

A118890 Issued in CA

Practice address

16420 Perris Blvd Ste Q
Moreno Valley, CA 92551-1136

Phone

(951) 571-2450

Fax

(915) 571-2455

NPI assigned

Apr 28, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mrs. Reena Devaraj Professional name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• American Current Care of California, a Medical Corporation

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1750573622
  Medicare reassignment NPD
• American Current Care of California, a Medical Corporation

  • Urgent Care Clinic/Center
  • South San Francisco, CA
  • NPI 1396294682
  NPD
• Riverside Medical Clinic, Inc

  • Dermatology Physician
  • Riverside, CA
  • NPI 1720183403
  NPD
• Riverside Medical Clinic, Inc

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1730180415
  NPD

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442966400000",
    "number": "1962677146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16420 PERRIS BLVD STE Q",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925511136",
            "telephone_number": "951-571-2450",
            "fax_number": "915-571-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16420 PERRIS BLVD STE Q",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925511136",
            "telephone_number": "951-571-2450",
            "fax_number": "915-571-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVARAJ",
        "first_name": "REENA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-28",
        "last_updated": "2015-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A118890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962677146",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REENA",
            "last_name": "DEVARAJ",
            "prefix": "MRS.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Desai & Patel DDS Inc.
• Sandip J Desai, DDS, MS
• Desert Trails Psychology, Professional Corporation
• Destiny Home Health Agency Inc
• Destiny Hospice Care, Inc
• Tristyn Deveau
• Developmental Client Care
• Developmental Client Care
• Developmental Client Care
• Developmental Client Care

• Specialist in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.