Individual provider Active NPI

Fareeha Sial

  • Physician Assistant
  • Moreno Valley, CA
National Provider Identifier
1124676168
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
57097 Issued in CA
Practice address
13524 Baneberry St
Moreno Valley, CA 92553-4822
Phone
(619) 750-9752
NPI assigned
Sep 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 57097 CA Primary

Addresses

Primary practice location

13524 Baneberry St
Moreno Valley, CA 92553-4822

Mailing address

13524 Baneberry St
Moreno Valley, CA 92553-4822
Phone (619) 750-9752

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
I20191210002074 CA Practitioner - Physician Assistant 0143653873 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
57097CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Unicare Community Health Center, Inc. CurrentSince Mar 18, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Apr 16, 2020 Accepting new patients
Tri-State Community Healthcare Center CurrentSince May 18, 2025 Accepting new patients
Unicare Community Health Center, Inc. CurrentSince Mar 18, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Apr 16, 2020 Accepting new patients
PRN Urgent Care, Inc. Past Accepting new patients

Locations

11888 Bartlett Ave
Adelanto, CA 92301
Phone (760) 530-9944

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

107 N McKinley St
Corona, CA 92879
Phone (951) 358-0141

1535 E Colorado St
Glendale, CA 91205

12021 Jacaranda Ave
Hesperia, CA 92345
Phone (909) 558-4207

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26520 Cactus Ave
Ste 2021
Moreno Valley, CA 92555
Phone (951) 486-5700

28078 Baxter Rd
Murrieta, CA 92563
Phone (951) 290-4000

820 W Broadway St
Needles, CA 92363
Phone (730) 326-0222

1151 E Walnut St
Ontario, CA 91761
Phone (909) 467-0797

437 N Euclid Ave
Ontario, CA 91762
Phone (909) 749-1835

1501 E Holt Ave
Ste A
Pomona, CA 91767
Phone (909) 623-3600

3762 Tibbetts St
Riverside, CA 92506
Phone (951) 686-2224

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1124676168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13524 BANEBERRY ST",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925534822",
            "telephone_number": "619-750-9752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13524 BANEBERRY ST",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925534822",
            "telephone_number": "619-750-9752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIAL",
        "first_name": "FAREEHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-03",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.