Individual provider Active NPI

Lirong Zhu

  • Family Nurse Practitioner
  • Loma Linda, CA
National Provider Identifier
1124609532
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95017791 Issued in CA
Practice address
11169 Rosarita Dr
Loma Linda, CA 92354-3207
Phone
(909) 642-3665
NPI assigned
Apr 16, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 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 95017791 CA Primary

Addresses

Primary practice location

11169 Rosarita Dr
Loma Linda, CA 92354-3207

Mailing address

11169 Rosarita Dr
Loma Linda, CA 92354-3207
Phone (909) 642-3665

Other practice location 1

18310 Hwy 18
2nd Floor
Apple Valley, CA 92307
Phone (760) 998-2312

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
I20250918002631 CA Practitioner - Nurse Practitioner 1951805340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

18310 US Hwy 18
Suite 200
Apple Valley, CA 92307-2206
Phone (760) 998-2312

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95017791CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Sep 3, 2025 Accepting new patients
Providence Medical Foundation CurrentSince Sep 3, 2025 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

18310 US Highway 18
Ste B
Apple Valley, CA 92307

18310 US Highway 18
Ste 200
Apple Valley, CA 92307
Phone (760) 998-2312

19333 Bear Valley Rd
Ste 106
Apple Valley, CA 92308
Phone (760) 240-5505

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

Organizations & group practices 4

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": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1124609532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11169 ROSARITA DR",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543207",
            "telephone_number": "909-642-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11169 ROSARITA DR",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543207",
            "telephone_number": "909-642-3665"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18310 Hwy 18",
            "address_2": "2nd Floor",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "CA",
            "postal_code": "92307",
            "country_code": "US",
            "telephone_number": "760-998-2312",
            "fax_number": "760-242-3371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZHU",
        "first_name": "LIRONG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-16",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.