Individual provider Active NPI

Tania Ponce, PA-C

  • Physician Assistant
  • Temecula, CA
National Provider Identifier
1356664890
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19451 Issued in CA
Practice address
31720 Temecula Pkwy
Suite 200
Temecula, CA 92592-5895
Phone
(951) 302-1576
NPI assigned
Mar 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA19451 CA Primary

Addresses

Primary practice location

31720 Temecula Pkwy
Suite 200
Temecula, CA 92592-5895

Mailing address

8161 E Kaiser Blvd Unit 28864
Anaheim, CA 92809-0480

Other practice location 1

2501 E Chapman Ave Ste 101
Orange, CA 92869-3204
Phone (714) 628-3300

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
I20160518001465 CA Practitioner - Physician Assistant 3072802883 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

100 E Valencia Mesa Dr
Suite 105
Fullerton, CA 92835-3816
Phone (714) 871-3006

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
19451CAMDAcupuncturist
PA19451CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Nov 13, 2023 Accepting new patients
Carbon Health Medical Group of California PC CurrentSince Jan 14, 2021 Accepting new patients
Providence Medical Foundation CurrentSince Nov 13, 2023 Accepting new patients
Stanley Arbiter MD Leonard Beller MD & Michael Silao MD Past Accepting new patients
Providence Medical Foundation Past Accepting new patients
St Jude Hospital Inc Past Accepting new patients

Locations

2690 5th St
Ste B
Alameda, CA 94501
Phone (510) 439-9447

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

14443 Culver Dr
#14443A
Irvine, CA 92604
Phone (949) 767-8173

2501 E Chapman Ave
Ste 101
Orange, CA 92869
Phone (714) 628-3300

2944 Tapo Canyon Rd
Ste A
Simi Valley, CA 93063
Phone (805) 306-5990

Interoperability endpoints

  • Direct secure messaging: tponce3088180@oc.providencedirect.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1356664890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8161 E KAISER BLVD UNIT 28864",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928090480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31720 TEMECULA PKWY",
            "address_2": "SUITE 200",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925925895",
            "telephone_number": "951-302-1576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 E Chapman Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928693204",
            "country_code": "US",
            "telephone_number": "714-628-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PONCE",
        "first_name": "TANIA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-11",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA19451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.