Individual provider Active NPI

Andrea Underwood, NNP

  • Neonatal Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1972190643
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
95015187 Issued in CA
Practice address
2823 Fresno St
Fresno, CA 93721-1324
Phone
(559) 459-6000
NPI assigned
Dec 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LN0000X 95015187 CA Primary

Addresses

Primary practice location

2823 Fresno St
Fresno, CA 93721-1324

Mailing address

2279 Pine St
Hanford, CA 93230-1777

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241115001989 CA Practitioner - Nurse Practitioner 1850825621 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95015187CAMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jan 26, 2026 Accepting new patients
Community Health Partners Single Specialty CurrentSince Oct 9, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Single Specialty CurrentSince Jan 26, 2026 Accepting new patients
Faculty Physicians and Surgeons of Llusm Single Specialty Current Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

45 E River Park Pl W
Ste 104
Fresno, CA 93720
Phone (559) 320-0550

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

12021 Jacaranda Ave
Hesperia, CA 92345
Phone (909) 558-4207

7223 Church St
Ste C1
Highland, CA 92346
Phone (909) 425-3946

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11370 Anderson St
Ste 2600
Loma Linda, CA 92354
Phone (909) 558-2890

25845 Barton Rd
Ste F
Loma Linda, CA 92354
Phone (909) 558-2828

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

11441 Heacock St
Ste C
Moreno Valley, CA 92557
Phone (951) 247-5809

11401 Heacock St
Ste 330
Moreno Valley, CA 92557
Phone (951) 247-8697

28078 Baxter Rd
Murrieta, CA 92563
Phone (951) 290-4000

26780 Barton Rd
Redlands, CA 92373
Phone (909) 558-5174

2195 Club Center Dr
Ste A
Sn Bernrdno, CA 92408
Phone (909) 835-1750

901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779

805 W Acequia Ave
Ste 2D
Visalia, CA 93291
Phone (559) 622-8687

Organizations & group practices 5

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": "1609113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1972190643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2279 PINE ST",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932301777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211324",
            "telephone_number": "559-459-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "ANDREA",
        "credential": "NNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-28",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "CA",
            "license": "95015187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.