Individual provider Active NPI

Siwei Jiang, FNP-C

  • Family Nurse Practitioner
  • Victorville, CA
National Provider Identifier
1548059736
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95033438 Issued in CA
Practice address
15237 Eleventh St Ste a
Victorville, CA 92395-3736
Phone
(760) 662-7420
NPI assigned
May 5, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 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 95033438 CA Primary

Addresses

Primary practice location

15237 Eleventh St Ste a
Victorville, CA 92395-3736

Mailing address

6114 Gold Spirit St
Eastvale, CA 92880-0990
Phone (626) 215-3841

Other practice location 1

191 E Alessandro Blvd Ste 9-A
Riverside, CA 92508-5095
Phone (951) 780-3300

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

LicenseStateTypeSpecialty
95033438CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Grove Medical Corporation CurrentSince May 1, 2025 Accepting new patients
Victorville Pediatrics PastSince Jun 29, 2025 Accepting new patients
PRN Urgent Care, Inc. PastSince May 1, 2025 Accepting new patients
Golden State Primary Care Inc PastSince Jun 29, 2025 Accepting new patients

Locations

191 E Alessandro Blvd
Ste 9A
Riverside, CA 92508
Phone (951) 780-3300

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1746403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1548059736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6114 GOLD SPIRIT ST",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928800990",
            "telephone_number": "626-215-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15237 ELEVENTH ST STE A",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953736",
            "telephone_number": "760-662-7420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "191 E Alessandro Blvd Ste 9-A",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925085095",
            "country_code": "US",
            "telephone_number": "951-780-3300",
            "fax_number": "951-780-3303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIANG",
        "first_name": "SIWEI",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-05",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95033438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.