Kimberly Ta

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95018697 Issued in CA

Practice address

3110 E Guasti Rd Ste 315
Ontario, CA 91761-1258

Phone

(909) 942-5666

Fax

(909) 435-4202

NPI assigned

Dec 21, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seasons Medical Group of California IncorporatedGroup PAC ID 9234405952, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Seasons Medical Group of California Incorporated

  dba AccentCare Medical Group of California

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • San Diego, CA
  • NPI 1790239473

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Gracelight Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1104075282
  Medicare reassignment
• Seasons Hospice & Palliative Care of California- San Bernardino, LLC

  dba AccentCare Hospice & Palliative Care of California -San Bernardino

  • Community Based Hospice Care Agency
  • Ontario, CA
  • NPI 1336408848
  NPD (past)
• Seasons Hospice & Palliative Care of California- San Diego, LLC

  dba AccentCare Hospice & Palliative Care of California -San Diego

  • Community Based Hospice Care Agency
  • San Diego, CA
  • NPI 1457688954
  NPD (past)

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

{
    "created_epoch": "1640044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1639839418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 E GUASTI RD STE 315",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917611258",
            "telephone_number": "909-942-5666",
            "fax_number": "909-435-4202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 E GUASTI RD STE 315",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917611258",
            "telephone_number": "909-942-5666",
            "fax_number": "909-435-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TA",
        "first_name": "KIMBERLY",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-21",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95018697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Usman Syed I
• Jayna Sylvester
• Hailey Marie Szabo Zacarias
• Whitnie Szutu, OD
• Kim La Ta, PHARMD
• Maya Tabancura
• Paul Alexander Tablada
• Maria Esther Tadeo
• Maria Del Refugio Taffoya, COTA
• Giselle Tafolla

• Family Nurse Practitioner in Ontario, CA
• Providers in Ontario, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.