San Jose Integrated Clinic LLC
NPI 1386287753ActiveOrganization· Nurse Practitioner, Family· San Luis, AZ
Nurse Practitioner, Family in San Luis, Arizona, registered in NPPES in October 2019. The authorized official on file is Clarisse Vanessa Nguehanana, FNP, Ceo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1386287753 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 17, 2019 |
| Last updated in NPPES | Oct 17, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AZ) |
|---|
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