Individual provider Active NPI

Erica E Kim, NP

  • Family Nurse Practitioner
  • Moreno Valley, CA
National Provider Identifier
1124500087
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95009336 Issued in CA
Practice address
27640 Eucalyptus Ave
Moreno Valley, CA 92555-4557
Phone
(951) 243-2200
NPI assigned
Sep 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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 95009336 CA Primary

Addresses

Primary practice location

27640 Eucalyptus Ave
Moreno Valley, CA 92555-4557

Mailing address

255 Terracina Blvd Ste 205C
Redlands, CA 92373-4870

Other practice location 1

33494 Oak Glen Rd
Yucaipa, CA 92399-2057
Phone (909) 797-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230313002343 CA Practitioner - Nurse Practitioner 6406220557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Loma Linda University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Dermatology InstituteGroup PAC ID 2062546260, 32 clinicians

Practice addresses (Care Compare)

255 Terracina Blvd
Suite 205C
Redlands, CA 92373-4870
Phone (909) 793-2323

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95009336CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Dermatology Institute CurrentSince Mar 1, 2023 Accepting new patients
Dignity Health Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
Uhs Corona Inc Past Accepting new patients

Locations

18523 Corwin Rd
Ste G
Apple Valley, CA 92307
Phone (760) 242-3376

1481 Ford St
Ste 102
Redlands, CA 92373
Phone (909) 793-2323

1200 California St
Ste 210
Redlands, CA 92374
Phone (909) 693-3424

255 Terracina Blvd
Ste 205C
Redlands, CA 92373
Phone (909) 793-2323

9041 Magnolia Ave
Ste 206
Riverside, CA 92503
Phone (951) 354-0676

1666 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (888) 700-0881

12332 Hesperia Rd
Ste 2
Victorville, CA 92395
Phone (442) 232-4750

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1124500087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 TERRACINA BLVD STE 205C",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27640 EUCALYPTUS AVE",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925554557",
            "telephone_number": "951-243-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33494 Oak Glen Rd",
            "address_purpose": "LOCATION",
            "city": "Yucaipa",
            "state": "CA",
            "postal_code": "923992057",
            "country_code": "US",
            "telephone_number": "909-797-8900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "ERICA",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-06",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.