Individual provider Active NPI

Tricia Rose Fontanilla Alegado, FNP-C

  • Family Nurse Practitioner
  • Menifee, CA
National Provider Identifier
1336619451
Registry record updated Dec 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95010511 Issued in CA
Practice address
29740 Mesa Verde Cir
Menifee, CA 92584
Phone
(760) 807-4472
NPI assigned
Dec 1, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2018

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 95010511 CA Primary

Addresses

Primary practice location

29740 Mesa Verde Cir
Menifee, CA 92584

Mailing address

29740 Mesa Verde Cir
Menifee, CA 92584-7612
Phone (760) 807-4472

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
I20210318001808 CA Practitioner - Nurse Practitioner 3375883150 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95010511CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic Medical Group of Orange County Inc Family CurrentSince May 1, 2020 Accepting new patients

Locations

2456 S Grove Ave
Ontario, CA 91761
Phone (909) 947-9390

11428 Kenyon Way
Rancho Cucamonga, CA 91701
Phone (909) 589-4098

491 E Alessandro Blvd
Riverside, CA 92508
Phone (951) 780-1835

921 Pacific Coast Hwy
Seal Beach, CA 90740
Phone (562) 598-0473

33205 US Highway 79
Temecula, CA 92592
Phone (951) 303-3064

Interoperability endpoints

  • Direct secure messaging: talegado337964@direct.llu.edu
  • Direct secure messaging: talegado567276@hisp.ehr.sutterhealth.org

Organizations & group practices 1

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": "1543622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543622400000",
    "number": "1336619451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29740 MESA VERDE CIR",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925847612",
            "telephone_number": "760-807-4472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29740 MESA VERDE CIR",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "92584",
            "telephone_number": "760-807-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEGADO",
        "first_name": "TRICIA ROSE",
        "middle_name": "FONTANILLA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-01",
        "last_updated": "2018-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95010511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menifee, CA

Sources for this page

Verify at the official NPI Registry.