Individual provider Active NPI

Jannelyn Panganiban Correa, FNP-C

  • Family Nurse Practitioner
  • Pomona, CA
National Provider Identifier
1679180863
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95014874 Issued in CA
Practice address
1450 E Holt Ave
Pomona, CA 91767-5822
Phone
(909) 630-7927
NPI assigned
Sep 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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 95014874 CA Primary

Addresses

Primary practice location

1450 E Holt Ave
Pomona, CA 91767-5822

Mailing address

1450 E Holt Ave
Pomona, CA 91767-5822

Other names 1

  • Jannelyn Panganiban Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20210219002368 CA Practitioner - Nurse Practitioner 4486069630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pomona Community Health CenterGroup PAC ID 5890940605, shared by 3 NPIs, 7 clinicians

Practice addresses (Care Compare)

2680 E Riverside Dr
Ontario, CA 91761-7307
Phone (909) 630-7927

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95014874CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 20, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 20, 2022 Accepting new patients
Pomona Community Health Center Past Accepting new patients
Pomona Community Health Center Past Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

411 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000

441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jennelyn.panganiban@398008301912068.direct.elationemr.com

Organizations & group practices 5

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": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1679180863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 E HOLT AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 E HOLT AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675822",
            "telephone_number": "909-630-7927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREA",
        "first_name": "JANNELYN",
        "middle_name": "PANGANIBAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-30",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95014874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JANNELYN",
            "last_name": "PANGANIBAN",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.