Individual provider Active NPI

Ashley Tashelle Crisostomo, FNP

  • Family Nurse Practitioner
  • Oxnard, CA
National Provider Identifier
1356862791
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
752488 Issued in CA
Practice address
631 Cooper Rd
Oxnard, CA 93030
Phone
(805) 487-9150
Fax
(805) 487-9152
NPI assigned
Jul 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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 752488 CA Primary

Addresses

Primary practice location

631 Cooper Rd
Oxnard, CA 93030

Mailing address

631 Cooper Rd
Oxnard, CA 93030
Phone (805) 487-9150

Other names 1

  • Ashley Casillas Former name

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
I20170825000472 CA Practitioner - Nurse Practitioner 7113299157 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
752488CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Simi Medical Group, Inc CurrentSince Oct 2, 2023 Accepting new patients
Family Healthcare Network CurrentSince Jul 11, 2017 Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network CurrentSince Jul 11, 2017 Accepting new patients

Locations

1107 W Poplar Ave
Porterville, CA 93257
Phone (559) 781-7242

2755 Alamo St
Ste 101
Simi Valley, CA 93065
Phone (805) 210-7280

9416 Road 238
Terra Bella, CA 93270
Phone (559) 741-4500

305 E Center Ave
Visalia, CA 93291
Phone (559) 737-4792

Interoperability endpoints

  • Direct secure messaging: ashley.crisostomo.p19@direct.regal.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/CCECCA

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": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1356862791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 COOPER RD",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "93030",
            "telephone_number": "805-487-9150",
            "fax_number": "805-487-9152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 COOPER RD",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "93030",
            "telephone_number": "805-487-9150",
            "fax_number": "805-487-9152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISOSTOMO",
        "first_name": "ASHLEY",
        "middle_name": "TASHELLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-06",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "752488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "CASILLAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.