Gwendolyn Mary Anderson, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95029377 Issued in CA

Practice address

1400 Barton Rd Apt 2905
Redlands, CA 92373-5444

Phone

(909) 283-8925

NPI assigned

Jul 23, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ganderson17084@direct-prd.molinahealthcare.com

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.

• Central Health Plan of California, Inc.

  • Health Maintenance Organization
  • Diamond Bar, CA
  • NPI 1386714772
  Medicare reassignment NPD
• Molina Healthcare of California

  • Health Maintenance Organization
  • Long Beach, CA
  • NPI 1194811760
  Medicare reassignment NPD
• Universal Care

  • Pediatrics Physician
  • Long Beach, CA
  • NPI 1376632877
  NPD

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1124637368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11262 CAMPUS STREET - WEST HALL",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BARTON RD APT 2905",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735444",
            "telephone_number": "909-283-8925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "GWENDOLYN",
        "middle_name": "MARY",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95029377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Anasco
• Jerome Untalan Ancheta
• Ruby Andaya, MA, LMFT
• Dale Andelkovic, D.C.
• Anderson Turner Nursing Inc.
• Kaitlin Anderson
• Lisa C Anderson, N.P.
• Matthew Clay Anderson, P.A.
• Megan L Anderson, FNP
• Michelle A Anderson, M.D.

• Family Nurse Practitioner in Redlands, CA
• Providers in Redlands, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.