Individual provider Active NPI

Beverly Balamad Mosqueda, NP

  • Family Nurse Practitioner
  • Rancho Cucamonga, CA
National Provider Identifier
1700201779
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95000445 Issued in CA
Practice address
9471 Jack Rabbit Dr
104
Rancho Cucamonga, CA 91730-2776
Phone
(626) 384-1585
NPI assigned
Feb 26, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 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 95000445 CA Primary

Addresses

Primary practice location

9471 Jack Rabbit Dr
104
Rancho Cucamonga, CA 91730-2776

Mailing address

9471 Jack Rabbit Dr Unit 104
Rancho Cucamonga, CA 91730-2777
Phone (949) 922-3457

Other names 1

  • Beverly Balamad Tsun Former name

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
I20251017002220 CA Practitioner - Nurse Practitioner 6901107317 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinity Mobile Medical GroupGroup PAC ID 7214466374, 20 clinicians

Practice addresses (Care Compare)

17337 Ventura Blvd
Suite 220
Encino, CA 91316-4039
Phone (818) 418-4440

Hospital & facility affiliations

  • Empress Healthcare, Inc Home health agency, Chatsworth, CA, CCN 757523

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Marketing Worldwide Inc. CurrentSince Feb 2, 2026 Accepting new patients
Adobe PH Ca Medical Group, P.C. CurrentSince Jan 23, 2026 Accepting new patients
Infinity Mobile Medical Group CurrentSince Sep 1, 2025 Accepting new patients

Locations

7500 N Dreamy Draw Dr
Ste 100
Phoenix, AZ 85020
Phone (520) 233-7111

135 S State College Blvd
#228
Brea, CA 92821

17337 Ventura Blvd
Ste 220
Encino, CA 91316
Phone (818) 418-4440

5015 Eagle Rock Blvd
Ste 200
Los Angeles, CA 90041
Phone (323) 455-4868

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1393372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1700201779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9471 JACK RABBIT DR UNIT 104",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917302777",
            "telephone_number": "949-922-3457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9471 JACK RABBIT DR",
            "address_2": "104",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917302776",
            "telephone_number": "626-384-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSQUEDA",
        "first_name": "BEVERLY",
        "middle_name": "BALAMAD",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-26",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95000445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEVERLY",
            "last_name": "TSUN",
            "middle_name": "BALAMAD",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.