Individual provider Active NPI

Jessica Talbot, FNP

  • Nurse Practitioner
  • Grand Terrace, CA
National Provider Identifier
1407492283
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95013096 Issued in CA
Practice address
11980 Mount Vernon Ave
Grand Terrace, CA 92313-5172
Phone
(909) 864-1097
NPI assigned
Nov 26, 2019
Last updated
Feb 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95013096 CA Primary

Addresses

Primary practice location

11980 Mount Vernon Ave
Grand Terrace, CA 92313-5172

Mailing address

9631 Dumbreck Dr
Huntington Beach, CA 92646-6004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201118002606 CA Practitioner - Nurse Practitioner 8628489804 Reassigns benefits to 1 organization
I20210814000027 TX Practitioner - Nurse Practitioner 8628489804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11555 /2 Potrero Rd
Banning, CA 92220-6946
Phone (951) 849-4761

11980 Mount Vernon Ave
Grand Terrace, CA 92313-5172
Phone (909) 864-1097

23119 Soboba Rd
Soboba Indian Health Clinic
San Jacinto, CA 92583-5517
Phone (951) 654-0803

66655 Martinez Rd
Torres Martinez Indian HLTH Clin
Thermal, CA 92274-9007
Phone (760) 397-4476

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95013096CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside-San Bernardino County Indian Health, Inc. Current Accepting new patients
Riverside-San Bernardino County Indian Health, Inc CurrentSince Jul 15, 2021 Accepting new patients
Riverside-San Bernardino County Indian Health, Inc. CurrentSince Jul 15, 2021 Accepting new patients
Advanced Medical and Urgent Care Center CurrentSince Oct 24, 2020 Accepting new patients
Dalia Dawoud MD Inc Past Accepting new patients
Dalia Dawoud MD Inc Past Accepting new patients

Locations

11980 Mount Vernon Ave
Grand Terrace, CA 92313
Phone (909) 783-8470

974 W Foothill Blvd
Upland, CA 91786
Phone (909) 932-1122

Organizations & group practices 6

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": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1407492283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9631 DUMBRECK DR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926466004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11980 MOUNT VERNON AVE",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135172",
            "telephone_number": "909-864-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALBOT",
        "first_name": "JESSICA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-26",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95013096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Terrace, CA

Sources for this page

Verify at the official NPI Registry.