Individual provider Active NPI

Veronica D Wang, NP

  • Family Nurse Practitioner
  • Glendora, CA
National Provider Identifier
1164092862
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95020173 Issued in CA
Practice address
130 N Grand Ave
Glendora, CA 91741-2434
Phone
(626) 963-0385
NPI assigned
Jun 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Inpatient Obstetric Registered Nurse 163WX0003X 95049360 CA
Family Nurse Practitioner 363LF0000X 95020173 CA Primary

Addresses

Primary practice location

130 N Grand Ave
Glendora, CA 91741-2434

Mailing address

4003 Quartzite LN
San Bernardino, CA 92407-0468
Phone (909) 908-2658

Other practice location 1

9333 Imperial Hwy
Downey, CA 90242-2812
Phone (909) 908-2658

Other names 1

  • Veronica D Dionisio Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20230127001010 CA Practitioner - Nurse Practitioner 6204207368 Reassigns benefits to 5 organizations

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
Southern California Permanente Medical GroupGroup PAC ID 6002729175, shared by 4 NPIs, 11,250 clinicians

Practice addresses (Care Compare)

250 W San Jose Ave
Claremont, CA 91711-5207
Phone (909) 625-2311

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95049360CAMDInpatient Obstetric Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Feb 16, 2025 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Minuteclinic Diagnostic Medical Group of California Inc Family CurrentSince Dec 28, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 16, 2025 Accepting new patients
Minuteclinic Diagnostic Medical Group of Orange County Inc Family CurrentSince Dec 28, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 16, 2025 Accepting new patients
Minuteclinic Diagnostic Medical Group of San Diego Inc Family CurrentSince Dec 28, 2022 Accepting new patients

Locations

1401 S Baldwin Ave
Arcadia, CA 91007
Phone (626) 321-4210

250 W San Jose Ave
Claremont, CA 91711
Phone (866) 889-8555

9333 Imperial Hwy
Downey, CA 90242
Phone (562) 657-8850

2760 Fletcher Pkwy
El Cajon, CA 92020
Phone 6194614411 ext. 8221

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

130 N Grand Ave
Glendora, CA 91741
Phone (626) 963-0385

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

11428 Kenyon Way
Rancho Cucamonga, CA 91701
Phone (909) 589-4098

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

921 Pacific Coast Hwy
Seal Beach, CA 90740
Phone (562) 598-0473

33205 US Highway 79
Temecula, CA 92592
Phone (951) 303-3154

2791 Agoura Rd
Westlake Village, CA 91361
Phone 8054954938 ext. 8221

Organizations & group practices 7

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": "1624579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1164092862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4003 QUARTZITE LN",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924070468",
            "telephone_number": "909-908-2658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917412434",
            "telephone_number": "626-963-0385"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9333 Imperial Hwy",
            "address_purpose": "LOCATION",
            "city": "Downey",
            "state": "CA",
            "postal_code": "902422812",
            "country_code": "US",
            "telephone_number": "909-908-2658",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "VERONICA",
        "middle_name": "D",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-25",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Obstetric, Inpatient",
            "state": "CA",
            "license": "95049360",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95020173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "VERONICA",
            "last_name": "DIONISIO",
            "middle_name": "D",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.