Active NPI
Tynesha Wade, CPNP-AC
- Critical Care Pediatric Nurse Practitioner
- Orange, CA
National Provider Identifier
1487591483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Pediatric Nurse Practitioner
- License
- 95038465
- Practice address
- 1201 W la Veta Ave
Orange, CA 92868-4203 - Phone
- (714) 203-2181
- NPI assigned
- Apr 29, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Pediatric Nurse Practitioner | 363LP0222X | 95038465 | CA | Primary |
Addresses
Primary practice location
1201 W la Veta Ave
Orange, CA 92868-4203
Mailing address
13064 Thicket PL
Corona, CA 92883-6347
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95038465 | CA | MD | Critical Care Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1777420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777420800000",
"number": "1487591483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13064 THICKET PL",
"city": "CORONA",
"state": "CA",
"postal_code": "928836347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 W LA VETA AVE",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684203",
"telephone_number": "714-203-2181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "TYNESHA",
"credential": "CPNP-AC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-04-29",
"last_updated": "2026-04-29",
"certification_date": "2026-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0222X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics, Critical Care",
"state": "CA",
"license": "95038465",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.