Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tara Antonucci, AGACNP-BC

Individual provider Acute Care Nurse Practitioner · NPI 1598476038

Tara Antonucci, AGACNP-BC is a Nurse Practitioner in San Diego, California. Qualified in 2022, 4 years ago. Practices with Regents of the University of California, a 2,061-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
4
Licensed in
CA
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

200 W Arbor Dr
San Diego, CA 92103-9000
Phone: (800) 926-8273
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 9434 Medical Center Dr, La Jolla, CA 92037-1337 — (858) 657-8330

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 95021759 (CA)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence 95021759 (CA)

Record details

NPI number1598476038
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP-BC
Sole proprietorNo
NPI enumeratedDecember 6, 2022
Last updated in NPPESApril 5, 2023
Certification dateApril 5, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Regents Of The University Of California — 2061 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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