Individual provider Active NPI

Amalyn Mejia, FNP-C

  • Family Nurse Practitioner
  • Colton, CA
National Provider Identifier
1386407823
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95029158 Issued in CA
Practice address
1007 E Cooley Dr Ste 103
Colton, CA 92324-3901
Phone
(951) 727-6460
NPI assigned
Feb 6, 2024
Last updated
Aug 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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 95029158 CA Primary

Addresses

Primary practice location

1007 E Cooley Dr Ste 103
Colton, CA 92324-3901

Mailing address

12064 Malachite CT
Jurupa Valley, CA 91752-4462
Phone (909) 663-7345

Other practice location 1

701 Highland Springs Ave
Beaumont, CA 92223-2550
Phone (951) 845-2342

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE)

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
I20251208003420 CA Practitioner - Nurse Practitioner 5597255802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1007 E Cooley Dr
Suite 103
Colton, CA 92324-3901

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95029158CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
M Healthcare Nursing Corp CurrentSince Jan 7, 2025 Accepting new patients

Locations

1007 E Cooley Dr
Ste 103
Colton, CA 92324
Phone (951) 727-6460

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": "1707177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1386407823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12064 MALACHITE CT",
            "city": "JURUPA VALLEY",
            "state": "CA",
            "postal_code": "917524462",
            "telephone_number": "909-663-7345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 E COOLEY DR STE 103",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923243901",
            "telephone_number": "951-727-6460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Highland Springs Ave",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "CA",
            "postal_code": "922232550",
            "country_code": "US",
            "telephone_number": "951-845-2342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEJIA",
        "first_name": "AMALYN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-06",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95029158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "701 Highland Springs Ave",
            "city": "Beaumont",
            "state": "CA",
            "country_code": "US",
            "postal_code": "922232550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.