Angelina Abila
Individual provider Active NPI Family Nurse Practitioner · Riverside, CA
NPI 1720733967 · NPPES record last updated Mar 12, 2024
Key facts
- NPI
- 1720733967
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 95019052 (CA)
- Practice address
- 6117 Brockton Ave Ste 203
Riverside, CA 92506-2207 - Phone
- (951) 444-0502
- NPI assigned
- Feb 16, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Grace Medical and Wellness Clinic
Practice addresses (Care Compare)
6900 Brockton Ave
Suite 200
Riverside, CA 92506-3818
Phone (951) 682-6263
Hospital & facility affiliations
- Skilled Home Health, Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250401002884 | CA | Practitioner - Nurse Practitioner | 1658894555 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grace Medical and Wellness Clinic | Current |
Accepting new patients | |
| A Abila Nursing FNP Inc | Family | Past |
Accepting new patients |
Locations
6900 Brockton Ave
Ste 200
Riverside, CA 92506
Phone (951) 682-6263
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95019052 | CA | Yes |
Addresses
Primary practice location
6117 Brockton Ave Ste 203
Riverside, CA 92506-2207
Mailing address
6117 Brockton Ave Ste 203
Riverside, CA 92506-2207
Phone (951) 444-0502
Other providers in Riverside, CA
- Christian Abel
- Nirusha Achini Abeydeera
- Thilini Anne Abeygunaratne
- Elaine Abich
- Syeda Batool Abidi
- Frances Martinez Abila
- Ability Pathways Inc
- Hilal Abo
- Alyssa Aboff
- Georges Abou Rjaili
All providers in Riverside, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.