Kimberly-Nicolle Valdez Singngam

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

95024174 Issued in CA

Practice address

11980 Mount Vernon Ave
Grand Terrace, CA 92313-5172

Phone

(909) 864-1097

Fax

(909) 864-1097

NPI assigned

May 3, 2021

Reactivated

May 12, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: ksingngam708823@direct.llu.edu

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1043894355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11980 MOUNT VERNON AVE",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135172",
            "telephone_number": "909-864-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11980 MOUNT VERNON AVE",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135172",
            "telephone_number": "909-864-1097",
            "fax_number": "909-864-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "replacement_npi": "1043894355",
        "last_name": "SINGNGAM",
        "first_name": "KIMBERLY-NICOLLE",
        "middle_name": "VALDEZ",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-03",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "deactivation_date": "2021-05-04",
        "reactivation_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95024174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elyssa Lorraine Shaw, ASW11761
• Anthony S Shin, M.D.
• Gerard Joseph Bernal Sim, OD
• Brittney Lynn Singh Young, DPT
• Dilpreet Singh
• Cirselda Aniag Siquian, RN
• Amber Joy Smith, LMFT
• Jazmin Smith
• St. Anthony'S Home Care, Inc.
• Olivia Elena Starace, P.T.-ASSIST

• Pediatric Nurse Practitioner in Grand Terrace, CA
• Providers in Grand Terrace, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.