Individual provider Active NPI

Christina Marie Mattle, NP

  • Nurse Practitioner
  • Loma Linda, CA
National Provider Identifier
1700456001
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP95031450 Issued in CA
Practice address
11234 Anderson St
Loma Linda, CA 92350-1716
Phone
(909) 558-2454
NPI assigned
Jun 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X F432042 NY
Nurse Practitioner 363L00000X NP95031450 CA Primary

Addresses

Primary practice location

11234 Anderson St
Loma Linda, CA 92350-1716

Mailing address

11234 Anderson St TRLR C
Loma Linda, CA 92350-1716
Phone (909) 558-4483

Other practice location 1

1555 Long Pond Rd
Rochester, NY 14626-4122
Phone (585) 723-7000

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
I20241217000450 CA Practitioner - Nurse Practitioner 4486181385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

25845 Barton Rd
Suite F
Loma Linda, CA 92354-3899
Phone (909) 558-2828

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F432042NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Nov 10, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Nov 10, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

25845 Barton Rd
Ste F
Loma Linda, CA 92354
Phone (909) 558-2828

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11234 Anderson St
Trlr C
Loma Linda, CA 92350
Phone (909) 558-4483

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

28078 Baxter Rd
Murrieta, CA 92563
Phone (951) 290-4000

197 E Caroline St
Ste 1400
San Bernardino, CA 92408
Phone (800) 548-3790

Interoperability endpoints

  • Direct secure messaging: cmattle1231443@direct.llu.edu

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.

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": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1700456001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST TRLR C",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501716",
            "telephone_number": "909-558-4483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501716",
            "telephone_number": "909-558-2454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1555 Long Pond Rd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146264122",
            "country_code": "US",
            "telephone_number": "585-723-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTLE",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F432042",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95031450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.