Active NPI
Maria Medina Cockerham, CNA
- Home Health Aide
- Banning, CA
National Provider Identifier
1972964716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 00879291
- Practice address
- 4925 Singing Hills Dr
Banning, CA 92220-6635 - Phone
- (949) 241-9653
- NPI assigned
- Mar 7, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 00879291 | CA | Primary |
Addresses
Primary practice location
4925 Singing Hills Dr
Banning, CA 92220-6635
Mailing address
4925 Singing Hills Dr
Banning, CA 92220-6635
Phone (949) 241-9653
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 |
|---|---|---|---|
| 00879291 | CA | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457308800000",
"number": "1972964716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4925 SINGING HILLS DR",
"city": "BANNING",
"state": "CA",
"postal_code": "922206635",
"telephone_number": "949-241-9653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4925 SINGING HILLS DR",
"city": "BANNING",
"state": "CA",
"postal_code": "922206635",
"telephone_number": "949-241-9653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA COCKERHAM",
"first_name": "MARIA",
"credential": "CNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-07",
"last_updated": "2016-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "CA",
"license": "00879291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Banning, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.