Individual provider Active NPI

Caroline Kimaiyo

  • Psychiatric/Mental Health Nurse Practitioner
  • Riverside, CA
National Provider Identifier
1407626294
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95027261 Issued in CA
Practice address
5900 Brockton Ave
Riverside, CA 92506-1862
Phone
(951) 275-8400
NPI assigned
Jan 3, 2024
Last updated
Mar 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95027261 CA Primary

Addresses

Primary practice location

5900 Brockton Ave
Riverside, CA 92506-1862

Mailing address

13135 Heacock St Apt 120
Moreno Valley, CA 92553-2803
Phone (714) 809-3898

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
I20250718004149 CA Practitioner - Nurse Practitioner 1658887492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Telemedicine Urgent Care IncGroup PAC ID 6305248428, 15 clinicians

Practice addresses (Care Compare)

5888 Edinger Ave
Huntington Beach, CA 92649-1705
Phone (714) 716-2900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95027261CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Telemedicine Urgent Care Inc CurrentSince Jun 1, 2025 Accepting new patients

Locations

1712 19th St
Ste 213
Bakersfield, CA 93301

5329 Office Center Ct
Ste 224
Bakersfield, CA 93309
Phone (661) 455-7770

131 E 17th St
Ste A
Costa Mesa, CA 92627
Phone (714) 716-2900

1272 Center Court Dr
Ste 105
Covina, CA 91724
Phone (626) 869-4004

5888 Edinger Ave
#100A
Huntingtn Bch, CA 92649

5888 Edinger Ave
Huntington Beach, CA 92649
Phone (714) 377-7469

4332 Katella Ave
Los Alamitos, CA 90720
Phone (562) 430-1235

4336 Katella Ave
Los Alamitos, CA 90720
Phone (562) 799-6000

1640 2nd St
Ste 209
Norco, CA 92860
Phone (951) 888-8033

1410 3rd St
Ste 12
Riverside, CA 92507
Phone (951) 274-0090

12860 Beach Blvd
Stanton, CA 90680

17612 17th St
Ste A
Tustin, CA 92780
Phone (714) 716-2900

1884 Eastman Ave
Ste 100
Ventura, CA 93003

1884 Eastman Ave
Ste 103
Ventura, CA 93003
Phone (805) 500-6080

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": "1704240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1407626294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13135 HEACOCK ST APT 120",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925532803",
            "telephone_number": "714-809-3898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925061862",
            "telephone_number": "951-275-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMAIYO",
        "first_name": "CAROLINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-03",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95027261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.