Michelle Perea Saupan, NP
Individual provider Active NPI Family Nurse Practitioner · Diamond Bar, CA
NPI 1336038892 · NPPES record last updated Jun 30, 2025
Key facts
- NPI
- 1336038892
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 95033937 (CA)
- Practice address
- 888 Brea Canyon Rd Ste 330
Diamond Bar, CA 91789-3095 - Phone
- (909) 594-3382
- NPI assigned
- Jun 30, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95033937 | CA | MD | Family Nurse Practitioner |
Practice roles (1 of 2)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairway Children'S Medical Group | Current |
Accepting new patients |
Locations
5385 Walnut Ave
Ste 6
Chino, CA 91710
Phone (909) 591-0311
888 Brea Canyon Rd
Ste 330
Diamond Bar, CA 91789
Phone (909) 594-3382
2707 E Valley Blvd
Ste 215
West Covina, CA 91792
Phone (909) 594-3382
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95033937 | CA | Yes |
Addresses
Primary practice location
888 Brea Canyon Rd Ste 330
Diamond Bar, CA 91789-3095
Mailing address
179 N Avenida Alipaz
Walnut, CA 91789-2239
Phone (626) 617-7360
Other providers in Diamond Bar, CA
- Noel Legarta Santillan
- Gizelle Santos
- Joanne Santos
- Vimal Naranbhai Satodiya
- Saturn Home Care Services Inc
- Todd Mark Schafer
- Sandee A Schuster
- Terry Wesley Scott
- SD Xray LLC
- Sdxray & Lab
All providers in Diamond Bar, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.