Individual provider Active NPI

Jocelyn Siupan Cedro, FNP

  • Family Nurse Practitioner
  • Rancho Cucamonga, CA
National Provider Identifier
1073214235
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95023908 Issued in CA
Practice address
10722 Arrow Rte Ste 814a
Rancho Cucamonga, CA 91730-4843
Phone
(818) 606-0789
Fax
(909) 527-3352
NPI assigned
Mar 15, 2023
Last updated
Mar 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95023908 CA Primary

Addresses

Primary practice location

10722 Arrow Rte Ste 814a
Rancho Cucamonga, CA 91730-4843

Mailing address

10722 Arrow Rte Ste 814a
Rancho Cucamonga, CA 91730-4843
Phone (818) 606-0789

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
95023908CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Apple Healthcare Inc CurrentSince Aug 18, 2024 Accepting new patients
Apple Healthcare, Inc. CurrentSince Mar 19, 2023 Accepting new patients

Locations

10722 Arrow Rte
Ste 814A
Rancho Cucamonga, CA 91730
Phone (909) 527-4690

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1073214235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10722 ARROW RTE STE 814A",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304843",
            "telephone_number": "818-606-0789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10722 ARROW RTE STE 814A",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304843",
            "telephone_number": "818-606-0789",
            "fax_number": "909-527-3352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEDRO",
        "first_name": "JOCELYN",
        "middle_name": "SIUPAN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95023908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.