Individual provider Active NPI

Mabel Asamoah Anti Asiedu

  • Adult Health Nurse Practitioner
  • Valley Center, CA
National Provider Identifier
1104215631
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
95016533 Issued in CA
Practice address
13305 Cultivate CT
Valley Center, CA 92082-6983
Phone
(877) 749-7428
Fax
(512) 628-3314
NPI assigned
Jan 21, 2015
Last updated
Nov 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 95016533 CA Primary
Adult Health Nurse Practitioner 363LA2200X 2015000861 MO

Addresses

Primary practice location

13305 Cultivate CT
Valley Center, CA 92082-6983

Mailing address

13305 Cultivate CT
Valley Center, CA 92082-6983
Phone (877) 749-7428

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, CA2 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
I20150311002411 MO Practitioner - Nurse Practitioner 2163748013 Reassigns benefits to 1 organization
I20210504001275 CA Practitioner - Nurse Practitioner 2163748013 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Del Sur HealthcareGroup PAC ID 1850827395, 61 clinicians

Practice addresses (Care Compare)

436 S Magnolia Ave
Suite 101
El Cajon, CA 92020-5219
Phone (760) 978-8596

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geri Connection CurrentSince Apr 12, 2023 Accepting new patients
Bay View Health Solutions CurrentSince Mar 3, 2025 Accepting new patients
SSM Select Rehab St Louis LLC CurrentSince Jan 27, 2015 Accepting new patients
Senior Medical Associates, Inc. CurrentSince Apr 27, 2022 Accepting new patients
SSM Select Rehab St. Louis, LLC CurrentSince Jan 27, 2015 Accepting new patients
Myndfull Care Management California PC CurrentSince Apr 12, 2023 Accepting new patients
Del Sur Healthcare CurrentSince Nov 1, 2024 Accepting new patients
Myndfull Care California PC CurrentSince Feb 18, 2024 Accepting new patients

Locations

1999 S Bascom Ave
Ste 700
Campbell, CA 95008
Phone (760) 978-8596

436 S Magnolia Ave
Ste 101
El Cajon, CA 92020
Phone (760) 978-8596

15644 Pomerado Rd
Ste 202
Poway, CA 92064
Phone (619) 320-8090

2810 Camino del Rio S
Ste 102
San Diego, CA 92108
Phone (619) 299-1419

8445 Camino Santa Fe
Ste 215
San Diego, CA 92121
Phone (619) 541-3246

3572 Solutions Ctr
Chicago, IL 60677

100 Medical Plz
Fl 5
Lake St Louis, MO 63367
Phone (636) 625-5200

1027 Bellevue Ave
Fl 3
Saint Louis, MO 63117
Phone (314) 473-1296

6420 Clayton Rd
#6
Saint Louis, MO 63117
Phone (314) 768-5300

1 Town and Country Market Pl
Warrenton, MO 63383
Phone (636) 235-3830

9436 W Lake Mead Blvd
Ste 5
Las Vegas, NV 89134
Phone (760) 978-8596

Organizations & group practices 8

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": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1104215631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13305 CULTIVATE CT",
            "city": "VALLEY CENTER",
            "state": "CA",
            "postal_code": "920826983",
            "telephone_number": "877-749-7428",
            "fax_number": "512-628-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13305 CULTIVATE CT",
            "city": "VALLEY CENTER",
            "state": "CA",
            "postal_code": "920826983",
            "telephone_number": "877-749-7428",
            "fax_number": "512-628-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTI ASIEDU",
        "first_name": "MABEL",
        "middle_name": "ASAMOAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-21",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95016533",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2015000861",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Center, CA

Sources for this page

Verify at the official NPI Registry.