Individual provider Active NPI

Tobin Visi Kallippurathu, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Corona, CA
National Provider Identifier
1508772591
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95041148 Issued in CA
Practice address
271 Mount Kilimanjaro CT
Corona, CA 92881-8385
Phone
(951) 403-3154
NPI assigned
Aug 20, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 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 95041148 CA Primary

Addresses

Primary practice location

271 Mount Kilimanjaro CT
Corona, CA 92881-8385

Mailing address

271 Mount Kilimanjaro CT
Corona, CA 92881-8385
Phone (951) 403-3154

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1787184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1508772591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 MOUNT KILIMANJARO CT",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928818385",
            "telephone_number": "951-403-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 MOUNT KILIMANJARO CT",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928818385",
            "telephone_number": "951-403-3154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLIPPURATHU",
        "first_name": "TOBIN",
        "middle_name": "VISI",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-20",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95041148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.

Verify at the official NPI Registry.