Individual provider Active NPI

Ashley Fonseca-Tweed, FNP-BC

  • Family Nurse Practitioner
  • Grand Terrace, CA
National Provider Identifier
1275316176
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95025817 Issued in CA
Practice address
11980 Mount Vernon Ave
Grand Terrace, CA 92313-5172
Phone
(909) 864-1097
NPI assigned
Aug 15, 2023
Last updated
Feb 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 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 Practitioner 363LF0000X 95025817 CA Primary

Addresses

Primary practice location

11980 Mount Vernon Ave
Grand Terrace, CA 92313-5172

Mailing address

14114 Business Center Dr Ste a
Moreno Valley, CA 92553-9113
Phone (951) 697-4133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240319002170 TX Practitioner - Nurse Practitioner 2264879808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11980 Mount Vernon Ave
Grand Terrace, CA 92313-5172
Phone (909) 864-1097

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95025817CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside-San Bernardino County Indian Health, Inc. Current Accepting new patients
Riverside-San Bernardino County Indian Health, Inc CurrentSince Feb 12, 2024 Accepting new patients
Riverside-San Bernardino County Indian Health, Inc. CurrentSince Feb 12, 2024 Accepting new patients

Locations

11555 Potrero Rd
#1-2
Banning, CA 92220
Phone (909) 849-4761

11980 Mount Vernon Ave
Grand Terrace, CA 92313
Phone (909) 783-8470

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1275316176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14114 BUSINESS CENTER DR STE A",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925539113",
            "telephone_number": "951-697-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11980 MOUNT VERNON AVE",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135172",
            "telephone_number": "909-864-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONSECA-TWEED",
        "first_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-15",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95025817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Terrace, CA

Sources for this page

Verify at the official NPI Registry.