Active NPI
Li Watkins, FNP-BC
- Family Nurse Practitioner
- Rialto, CA
National Provider Identifier
1114430238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95006406
- Practice address
- 280 N Riverside Avenue
Rialto, CA 92376 - Phone
- (909) 421-2121
- Fax
- (909) 421-0491
- NPI assigned
- Nov 10, 2017
- Reactivated
- Feb 20, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95006406 | CA | Primary |
Addresses
Primary practice location
280 N Riverside Avenue
Rialto, CA 92376
Mailing address
PO Box 1608
Rialto, CA 92377-1608
Phone (909) 421-2121
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
| License | State | Type | Specialty |
|---|---|---|---|
| 95006406 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550620800000",
"number": "1114430238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1608",
"city": "RIALTO",
"state": "CA",
"postal_code": "923771608",
"telephone_number": "909-421-2121",
"fax_number": "909-421-0491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "280 N RIVERSIDE AVENUE",
"city": "RIALTO",
"state": "CA",
"postal_code": "92376",
"telephone_number": "909-421-2121",
"fax_number": "909-421-0491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATKINS",
"first_name": "LI",
"name_prefix": "Ms.",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-10",
"last_updated": "2019-02-20",
"deactivation_date": "2018-02-14",
"reactivation_date": "2019-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95006406",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rialto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.