Christie Noelani Huddy

Key facts

NPI

1992455976

Entity type

Individual (NPI type 1)

Primary specialty

Primary Care Nurse Practitioner 363LP2300X

License

95019818 (CA)

Practice address

18740 Ventura Blvd Ste 102
Tarzana, CA 91356-6353

Phone

(818) 708-7668

NPI assigned

Mar 24, 2022

Reactivated

Aug 16, 2023

Sex

Female

Sole proprietor

Yes

Organizations & group practices 2

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.

• Coast to Coast Foot Doctors Podiatrist · Tarzana, CA · NPI 1558064246
  Medicare reassignment Care Compare group NPD CA
• Empire Wound Care General Practice Physician · Monrovia, CA · NPI 1710796792
  NPD

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coast to Coast Foot Doctors (5 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2023.

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1992455976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 PASEO GRACIA",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18740 VENTURA BLVD STE 102",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913566353",
            "telephone_number": "818-708-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDDY",
        "first_name": "CHRISTIE",
        "middle_name": "NOELANI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "deactivation_date": "2022-11-30",
        "reactivation_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95019818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

• Stephen J Howard, DDS
• Howell Healthcare Inc
• Hu-121 Inc.
• Der-How Huang, D.P.T., C.S.C.S
• Huddleston Hip & Knee Institute
• Alan Hudosh, CCAPP
• Bernard O. Hudson III, M.D.
• Anthony Brain Hughey
• Eric Hunter
• Mikaela Hurd

All providers in Tarzana, CA · Primary Care Nurse Practitioner in California