Blaise Njieya Djeugoue, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95006253 Issued in CA

Practice address

6136 Flagstaff Dr
Eastvale, CA 92880-4611

Phone

(310) 429-4619

NPI assigned

Aug 1, 2016

Last updated

Aug 6, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Keen Medical Group Inc

  • Occupational Health Nurse Practitioner
  • Hesperia, CA
  • NPI 1174901334
  NPD (past)

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

{
    "created_epoch": "1470009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1275086753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6136 FLAGSTAFF DR",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928804611",
            "telephone_number": "310-429-4619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6136 FLAGSTAFF DR",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928804611",
            "telephone_number": "310-429-4619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJEUGOUE",
        "first_name": "BLAISE",
        "middle_name": "NJIEYA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-01",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006253",
            "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": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6136 Flagstaff Dr",
            "city": "Eastvale",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928804611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mrinal Dhar, MD
• Dhruv Physician Assistant
• Evelyn P Diaz, BA
• Mardy Lindt Fionne Diaz
• Martha Alicia Diaz
• Quang DO, DC
• Peter Dung-Quoc Doan, MD
• Arvin John Liwag Domingo
• Robert Anthony Dominguez, MSW, LCSW
• Monique Dozier, LCSW

• Family Nurse Practitioner in Eastvale, CA
• Providers in Eastvale, 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 Aug 6, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.