Individual provider Active NPI

Idorenyin P Mbeke-Ekanem

  • Registered Nurse
  • Fontana, CA
National Provider Identifier
1043152291
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95348559 Issued in CA
Practice address
6048 Mira Vista LN
Fontana, CA 92336-5806
Phone
(909) 434-6602
NPI assigned
Apr 7, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95348559 CA Primary

Addresses

Primary practice location

6048 Mira Vista LN
Fontana, CA 92336-5806

Mailing address

6048 Mira Vista LN
Fontana, CA 92336-5806
Phone (909) 434-6602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95348559CAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1775520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1043152291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6048 MIRA VISTA LN",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365806",
            "telephone_number": "909-434-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6048 MIRA VISTA LN",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365806",
            "telephone_number": "909-434-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBEKE-EKANEM",
        "first_name": "IDORENYIN",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-07",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95348559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.