Ashley Jeanine Tan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A200185 Issued in CA

Practice address

12980 Frederick St Ste D
Moreno Valley, CA 92553-5263

Phone

(951) 486-2744

NPI assigned

Jun 15, 2022

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Specialty

Family Practice

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1053041509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241819",
            "telephone_number": "909-580-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12980 FREDERICK ST STE D",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925535263",
            "telephone_number": "951-486-2744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N Pepper Ave",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923241819",
            "country_code": "US",
            "telephone_number": "909-580-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAN",
        "first_name": "ASHLEY",
        "middle_name": "JEANINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-15",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A200185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Take Flight Therapy
• Talk Techniques Family Therapy Services Inc
• Hanson Tam, PHARMD
• Sunny Tam, DO
• Antonio A. Tan, M.D.
• Evani S Tan, PHARMD
• Gordon Tan, M.D.
• Jiayan Tan
• Olivia Tandadjaja
• Jeffrey Tang

• Family Medicine Physician in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.