Individual provider Active NPI

Perpetua Mwangi, CRNP

  • Registered Nurse
  • Diamond Bar, CA
National Provider Identifier
1407557416
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4726253 Issued in CA
Practice address
211 Tanforan LN
Diamond Bar, CA 91765-1428
Phone
(302) 465-4422
NPI assigned
Mar 15, 2023
Last updated
Aug 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP026987 PA
Registered Nurse 163W00000X 4726253 CA Primary

Addresses

Primary practice location

211 Tanforan LN
Diamond Bar, CA 91765-1428

Mailing address

211 Tanforan LN
Diamond Bar, CA 91765-1428
Phone (302) 465-4422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20230524002319 PA Practitioner - Nurse Practitioner 3971969551 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4726253CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Health Partners Community Health Center Current Accepting new patients

Locations

1627 Chew St
Fl 1
Allentown, PA 18102
Phone (610) 969-2800

Organizations & group practices 2

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": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1407557416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 TANFORAN LN",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917651428",
            "telephone_number": "302-465-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 TANFORAN LN",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917651428",
            "telephone_number": "302-465-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MWANGI",
        "first_name": "PERPETUA",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-15",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP026987",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "4726253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamond Bar, CA

Sources for this page

Verify at the official NPI Registry.