Individual provider Active NPI

Krisolito Mones Labarda, FNP

  • Family Nurse Practitioner
  • Rancho Cucamonga, CA
National Provider Identifier
1336502582
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95003981 Issued in CA
Practice address
6299 Filly CT
Rancho Cucamonga, CA 91739-9590
Phone
(909) 319-9911
NPI assigned
Apr 4, 2016
Last updated
Oct 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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 95003981 CA Primary

Addresses

Primary practice location

6299 Filly CT
Rancho Cucamonga, CA 91739-9590

Mailing address

6299 Filly CT
Rancho Cucamonga, CA 91739-9590
Phone (909) 319-9911

Other identifiers 2

IdentifierTypeStateIssuer
F0316485OtherCAAMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION
95003981OtherCACALIFORNIA BOARD OF REGISTERED NURSING NURSE PRACTITIONER FURNISHING

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
I20160823001570 CA Practitioner - Nurse Practitioner 6002101599 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10800 Magnolia Ave
Riverside, CA 92505-3043
Phone (951) 353-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95003981CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Aug 11, 2019 Accepting new patients
Cep America - California Current Accepting new patients
Cep America - California CurrentSince Sep 1, 2016 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 11, 2019 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Cep America-California CurrentSince Sep 1, 2016 Accepting new patients
Riverside Emergency Physicians Medical Group CurrentSince Jun 5, 2019 Accepting new patients

Locations

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

3865 Jackson St
Riverside, CA 92503
Phone (909) 688-2211

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

4401 W Memorial Rd
Ste 121
Oklahoma City, OK 73134
Phone (405) 749-4560

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

Hospital & facility affiliations 1

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": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1336502582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6299 FILLY CT",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917399590",
            "telephone_number": "909-319-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6299 FILLY CT",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917399590",
            "telephone_number": "909-319-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABARDA",
        "first_name": "KRISOLITO",
        "middle_name": "MONES",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-04",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION",
            "identifier": "F0316485",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF REGISTERED NURSING NURSE PRACTITIONER FURNISHING",
            "identifier": "95003981",
            "state": "CA"
        }
    ],
    "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": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.