Individual provider Active NPI

Trisha Jane Paniagua

  • Psychiatric/Mental Health Nurse Practitioner
  • Fontana, CA
National Provider Identifier
1720779127
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95025222 Issued in CA
Practice address
9310 Sierra Ave
Fontana, CA 92335-5711
Phone
(866) 205-3595
NPI assigned
May 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95025222 CA Primary

Addresses

Primary practice location

9310 Sierra Ave
Fontana, CA 92335-5711

Mailing address

2058 N Mills Ave # 302
Claremont, CA 91711-2812
Phone (909) 319-9371

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
I20240308001789 CA Practitioner - Nurse Practitioner 9638515927 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thriveworks Clinical - California PCGroup PAC ID 1759785645, 55 clinicians

Practice addresses (Care Compare)

731 N Beach Blvd
Suite 140
La Habra, CA 90631-3689
Phone (855) 284-7483

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95025222CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brittany Watson NP Nursing Corporation Psychiatric/Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Thriveworks Clinical - California PC CurrentSince Jan 24, 2025 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 11, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 11, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

9310 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3700

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

18652 Florida St
Ste 245
Huntington Beach, CA 92648
Phone (714) 698-3460

731 N Beach Blvd
Ste 140
La Habra, CA 90631
Phone (562) 303-5925

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

116 S Catalina Ave
Ste 109
Redondo Beach, CA 90277
Phone (617) 454-4916

1401 N El Camino Real
Ste 100
San Clemente, CA 92672
Phone (858) 522-0145

4420 Hotel Circle Ct
Ste 200
San Diego, CA 92108
Phone (619) 933-2165

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

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": "1684195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1720779127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2058 N MILLS AVE # 302",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917112812",
            "telephone_number": "909-319-9371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9310 SIERRA AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923355711",
            "telephone_number": "866-205-3595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANIAGUA",
        "first_name": "TRISHA",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-16",
        "last_updated": "2024-12-30",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95025222",
            "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": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.