EPISOURCE LLC (NPI# 1225390289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225390289 |
| Entity Type | Organization |
| Organization Name | EPISOURCE LLC |
| Practice Address |
500 W 190th St 4th Floor Gardena CA 90248-4268 |
| Practice Telephone | 7144521961 |
| Practice Fax Number | 7144521966 |
| Mailing Telephone | 7144521961 |
| Mailing Fax Number | 7144521966 |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2020-07-30 |
| Authorized Official Name | MR. SISHIR REDDY (CEO) |
| Authorized Official Telephone | 7144521962 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | EPISOURCE LLC | 500 W. 190th Street, Fourth Floor, Gardena, Ca 90248 |
| Street Address |
500 W 190TH ST 4TH FLOOR |
| City | GARDENA |
| State | CA |
| Zip Code | 90248-4268 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699319103 | Nathalie Anyakpor | Family Medicine | 500 W 190th St, Gardena, CA 90248-4268 | 2019-10-29 |
| 1558805150 | Vanessa Angulo | Behavioral Analyst | 500 W 190th St, #220, Gardena, CA 90248-4268 | 2016-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215537543 | Gereine Mae Condino Datan | Nurse Practitioner | 500 W 190 St, Gardena, CA 90248 | 2020-10-27 |
| 1154811297 | Patrick Lee | Technician/Technologist | 18203 S. Western Ave Ste. 102, Torrance, CA 90248 | 2018-05-15 |
| 1386152445 | Ariana Felicitas Nieves | Behavioral Analyst | 870 W 190th St Ste 400, Gardena, CA 90248 | 2018-01-11 |
| 1265949606 | Jessica Keller | Behavioral Analyst | 879 W 190th St Suite 400, Gardena, CA 90248 | 2018-01-08 |
| 1265941199 | Jaimee E Munson | Behavioral Analyst | 18726 S. Western Ave St, #408, Gardena, CA 90248 | 2017-09-22 |
| 1922467349 | Fred Jefferson Memorial Homes | Substance Abuse Rehabilitation Facility | 152 W. Walnut, Suite 150, Gardena, CA 90248 | 2016-02-12 |
| 1922427442 | Shana Reilly | Behavioral Analyst | 18726 S. Western Ave., Suite 408, Los Angeles, CA 90248 | 2014-04-11 |
| 1588002216 | Aacres Ca, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 19300 S. Hamilton Ave, Ste 130, Gardena, CA 90248 | 2013-06-04 |
| 1093057598 | Aids Health Foundation | Pharmacist | 19300 S. Hamilton Ave., Ste 170, Gardena, CA 90248 | 2013-03-22 |
| 1245576594 | Hye Mi Kim | Behavioral Analyst | 18726 S. Western Ave.,#408, Gardena, CA 90248 | 2012-12-13 |
| Find all providers in zip 90248 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215537543 | Gereine Mae Condino Datan | Nurse Practitioner | 500 W 190 St, Gardena, CA 90248 | 2020-10-27 |
| 1760972665 | Michelle Wells | Nurse Practitioner | 500 W 190th St Fl 4, Gardena, CA 90248-4268 | 2018-05-16 |
| 1154745529 | Cathy Oh | Nurse Practitioner | 1116 W 161st St, Gardena, CA 90247-4416 | 2014-02-05 |
| 1316388937 | Charles E Smith | Nurse Practitioner | 15803 S Maple Ave, Gardena, CA 90248-2534 | 2013-07-11 |
| 1730228388 | Markeshia Clarke | Nurse Practitioner | 742 W Gardena Blvd, Gardena, CA 90247-5024 | 2007-02-06 |
| 1568942506 | Kemella Sillah | Nurse Practitioner | 500 W 190th St Fl 4, Gardena, CA 90248-4268 | 2018-08-20 |
| 1053705533 | Anna Smith | Nurse Practitioner | 15803 S Maple Ave, Gardena, CA 90248-2534 | 2015-03-24 |
| 1891118477 | Christine Marie Gutierrez | Nurse Practitioner | 1045 W Redondo Beach Blvd, St 500, Gardena, CA 90247-4128 | 2014-02-02 |
| 1306140637 | Rivy Olasumbo Oseni | Nurse Practitioner | 1300 W 155th St, Suite 103, Gardena, CA 90247-4048 | 2010-12-30 |
| 1609071422 | Lorna Ocampo-tatel | Nurse Practitioner | 742 W Gardena Blvd, Gardena, CA 90247-5024 | 2007-06-20 |
| Find all providers in GARDENA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.