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

Tracy-Jane Luyun Fajota, AGACNP-BC

Individual provider Acute Care Nurse Practitioner · NPI 1700660560

Tracy-Jane Luyun Fajota, AGACNP-BC is a Nurse Practitioner in Glendale, California. Qualified in 2023, 3 years ago. Practices with Antaki and Associates Infectious Disease Medical Group Inc, a 7-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
3
Licensed in
CA
In the registry since
2023
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1420 S Central Ave
Glendale, CA 91204-2508
Phone: (818) 502-1900
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 8510 Balboa Blvd Ste 150, Northridge, CA 91325-5810 — (818) 654-3400

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 95025937 (CA)

Record details

NPI number1700660560
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP-BC
Sole proprietorNo
NPI enumeratedAugust 22, 2023
Last updated in NPPESAugust 22, 2023
Certification dateAugust 22, 2023

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Antaki And Associates Infectious Disease Medical Group Inc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Glendale