Individual provider Active NPI

Janet Agu, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Downey, CA
National Provider Identifier
1982983508
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
23549 Issued in CA
Practice address
7765 Leeds St
Downey, CA 90242-3489
Phone
(844) 804-1933
NPI assigned
Aug 12, 2011
Last updated
Sep 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 533387 CA
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 533387 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 23549 CA Primary

Addresses

Primary practice location

7765 Leeds St
Downey, CA 90242-3489

Mailing address

11200 Lucas St
Cerritos, CA 90703-1626
Phone (424) 400-7748

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
I20160922001734 CA Practitioner - Nurse Practitioner 4183911928 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Renew Behavorial Health IncGroup PAC ID 9032115936, 4 clinicians

Practice addresses (Care Compare)

17777 Ctr Court Dr N
Cerritos, CA 90703-9320
Phone (562) 644-2216

4000 Long Beach Blvd
Suite 228
Long Beach, CA 90807-2617
Phone (562) 637-3143

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
533387CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mission City Community Network, Inc. CurrentSince Oct 8, 2019 Accepting new patients
Mission City Community Network, Inc. Current Accepting new patients
Mission City Community Network, Inc. CurrentSince Oct 8, 2019 Accepting new patients

Locations

15206 Parthenia St
Sepulveda, CA 91343

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1313107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1982983508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11200 LUCAS ST",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907031626",
            "telephone_number": "424-400-7748",
            "fax_number": "424-400-7749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7765 LEEDS ST",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902423489",
            "telephone_number": "844-804-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGU",
        "first_name": "JANET",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-12",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "533387",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "CA",
            "license": "533387",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "23549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

Verify at the official NPI Registry.