Individual provider Active NPI

Katarina Lum, FNP

  • Family Nurse Practitioner
  • Fremont, CA
National Provider Identifier
1538747654
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95017029 Issued in CA
Practice address
2191 Mowry Ave Ste 600B
Fremont, CA 94538-1702
Phone
(562) 490-9900
Fax
(562) 452-7078
NPI assigned
Mar 30, 2021
Last updated
Dec 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95017029 CA Primary

Addresses

Primary practice location

2191 Mowry Ave Ste 600B
Fremont, CA 94538-1702

Mailing address

4900 Airport Plaza Dr Ste 200
Long Beach, CA 90815-1375
Phone (562) 490-9900

Other practice location 1

701 E 28th St Ste 116
Long Beach, CA 90806-2771
Phone (562) 490-9900

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
I20221024001865 CA Practitioner - Nurse Practitioner 6901272517 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95017029CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tpirc Medical Foundation Inc CurrentSince Jul 20, 2025 Accepting new patients

Locations

2191 Mowry Ave
Ste 600B
Fremont, CA 94538
Phone (560) 490-9900

701 E 28th St
Ste 419
Long Beach, CA 90806
Phone (562) 353-5907

2704 E Willow St
Signal Hill, CA 90755
Phone (562) 595-0203

2067 W Vista Way
Ste 250
Vista, CA 92083
Phone (760) 724-7171

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11920/brand/1/csg/1/fhir/r4
  • Direct secure messaging: katarina.lum.1@11920.direct.athenahealth.com

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": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1538747654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 AIRPORT PLAZA DR STE 200",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151375",
            "telephone_number": "562-490-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2191 MOWRY AVE STE 600B",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381702",
            "telephone_number": "562-490-9900",
            "fax_number": "562-452-7078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 E 28th St Ste 116",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908062771",
            "country_code": "US",
            "telephone_number": "562-490-9900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUM",
        "first_name": "KATARINA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.