Individual provider Active NPI

Jessica Parra Terrazas

  • Dental Assistant
  • Pomona, CA
National Provider Identifier
1982139143
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
License
RDA87172 Issued in CA
Practice address
763 Rio Rancho Rd
Suite 120
Pomona, CA 91766-7015
Phone
(909) 766-1922
NPI assigned
Apr 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X RDA87172 CA Primary

Addresses

Primary practice location

763 Rio Rancho Rd
Suite 120
Pomona, CA 91766-7015

Mailing address

763 Rio Rancho Rd Ste 120
Pomona, CA 91766-7015

Other identifiers 1

IdentifierTypeStateIssuer
RDA87172MedicaidCA

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

LicenseStateTypeSpecialty
RDA87172CAMDDental Assistant

NPI Registry JSON

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1982139143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 RIO RANCHO RD STE 120",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917667015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 RIO RANCHO RD",
            "address_2": "SUITE 120",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917667015",
            "telephone_number": "909-766-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARRA TERRAZAS",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-25",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "CA",
            "license": "RDA87172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RDA87172",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; 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.