Individual provider Active NPI

John Melvin Wong Valenzuela, NP-C

  • Family Nurse Practitioner
  • Orange, CA
National Provider Identifier
1225775372
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95020509 Issued in CA
Practice address
845 W la Veta Ave Ste 105
Orange, CA 92868-3930
Phone
(714) 289-6565
Fax
(714) 289-6571
NPI assigned
May 18, 2022
Last updated
Jan 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 95020509 CA Primary

Addresses

Primary practice location

845 W la Veta Ave Ste 105
Orange, CA 92868-3930

Mailing address

845 W la Veta Ave Ste 105
Orange, CA 92868-3930
Phone (714) 289-6565

Other practice location 1

1100 W Stewart Dr
Orange, CA 92868-3849
Phone (714) 633-9111

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
I20260127000752 CA Practitioner - Nurse Practitioner 1254818768 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)

845 W la Veta Ave
Suite 105
Orange, CA 92868-3930
Phone (714) 289-6565

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95020509CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Dec 15, 2025 Accepting new patients
Providence Medical Foundation CurrentSince Dec 15, 2025 Accepting new patients
Vital Health Medical Group, Inc. Single Specialty PastSince Jan 1, 2023 Accepting new patients

Locations

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

1100 W Stewart Dr
Orange, CA 92868
Phone (714) 532-8620

845 W La Veta Ave
Ste 105
Orange, CA 92868
Phone (714) 289-6565

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1225775372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 W LA VETA AVE STE 105",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683930",
            "telephone_number": "714-289-6565",
            "fax_number": "714-289-6571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 W LA VETA AVE STE 105",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683930",
            "telephone_number": "714-289-6565",
            "fax_number": "714-289-6571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 W Stewart Dr",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683849",
            "country_code": "US",
            "telephone_number": "714-633-9111",
            "fax_number": "626-667-8781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALENZUELA",
        "first_name": "JOHN MELVIN",
        "middle_name": "WONG",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-18",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95020509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.