Individual provider Active NPI

Esther Y Lo, N.P.

  • Nurse Practitioner
  • Colton, CA
National Provider Identifier
1053340562
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10381 Issued in CA
Practice address
1181 N Mount Vernon Ave
Colton, CA 92324-2574
Phone
(909) 498-2356
Fax
(877) 824-9080
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10381 CA Primary

Addresses

Primary practice location

1181 N Mount Vernon Ave
Colton, CA 92324-2574

Mailing address

200 Oceangate
Suite 100
Long Beach, CA 90802-4317
Phone (909) 498-2356

Other identifiers 6

IdentifierTypeStateIssuer
EFF.10/21/13-COLTONMedicaidCA
EFF 2/20/13 RIALTOMedicaidCA
EFF. 5/17/13-SAN BERMedicaidCA
P01282960/DU4034OtherCARAILROAD MEDICARE
EFF.4/23/13-MORENOVAMedicaidCA
EFF.4/23/13-N.RIVERSMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040429001324 CA Practitioner - Nurse Practitioner 7012904055 Reassigns benefits to 1 organization
I20191220000726 TX Practitioner - Nurse Practitioner 7012904055 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside-San Bernardino County Indian Health, Inc CurrentSince Oct 1, 2019 Accepting new patients
Riverside-San Bernardino County Indian Health, Inc. CurrentSince Oct 1, 2019 Accepting new patients
Molina Healthcare of California Past Accepting new patients
Pinnacle Medical Group, Inc. Past Accepting new patients

Locations

11980 Mount Vernon Ave
Grand Terrace, CA 92313
Phone (909) 783-8470

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429747200000",
    "number": "1053340562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE",
            "address_2": "SUITE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "909-498-2356",
            "fax_number": "877-824-9080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1181 N MOUNT VERNON AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923242574",
            "telephone_number": "909-498-2356",
            "fax_number": "877-824-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LO",
        "first_name": "ESTHER",
        "middle_name": "Y",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2015-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "10381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EFF.10/21/13-COLTON",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EFF 2/20/13 RIALTO",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EFF. 5/17/13-SAN BER",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01282960/DU4034",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EFF.4/23/13-MORENOVA",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EFF.4/23/13-N.RIVERS",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.